How to deal with pharmacogenic myocarditis?

       Drug-sensitive myocarditis is also relatively rare in clinical practice and can be easily misdiagnosed. Data show that about 20 drugs can cause drug-sensitive myocarditis, mainly methyldopa, sulfonamide, penicillin, tetracycline, streptomycin, phenytoin sodium, botulinum toxin, and ambrisentin. These drugs can form an exogenous antigenic substance to individual atopic individuals, inducing the body to produce corresponding antibodies, and if re-exposed, they may form an antigenic antibody reaction, causing myocardial damage and presenting a myocardial metaplasia, called drug-sensitive myocarditis.  The clinical manifestations of drug-sensitive myocarditis are similar to those of rheumatic myocarditis, mainly manifesting as arrhythmias and conduction block, chest tightness, palpitations, and shortness of breath. If the myocardial damage is more extensive, it may also cause symptoms of poor blood supply to the brain such as dizziness and vertigo due to poor circulation.  Therefore, drug-sensitive myocarditis should be alerted when the following features are present: 1. a history of drug use; 2. clinical manifestations of myocardial damage mainly during continuous drug use, which may be accompanied by other allergic reactions such as skin allergic rash like urticaria, pruritus and asthma; 3. electrocardiographic evidence of arrhythmia and conduction block, and electrocardiogram may also show signs of myocardial ischemia. Laboratory tests have increased eosinophilia and increased blood sedimentation.  Therefore, it is important to pay attention to the choice of drugs, in addition to a clear understanding of their physical qualities selective use of drugs. A section of any abnormal reaction should be immediately to the hospital to identify the cause in time for early treatment.