Which sequence of symptoms may indicate myocarditis following myocardial infarction?

• A. Chest pain radiating to the jaw.
• B. Upper respiratory symptoms followed by heart failure symptoms.
• C. Dizziness followed by fainting.
• D. Severe leg swelling first.

Answer: (B)

A viral infection often sets the stage for myocarditis, with an initial upper respiratory illness (fever, malaise, myalgias) followed by signs of cardiac involvement such as heart failure symptoms (dyspnea, edema, fatigue) when inflammation weakens the heart muscle. This sequence—URI symptoms first, then heart failure signs—fits myocarditis best because the inflammatory process directly impairs myocardial function after the infection.

Chest pain radiating to the jaw is more typical of myocardial ischemia/infarction rather than a post-infectious inflammatory process. Dizziness followed by fainting suggests arrhythmia or conduction problems rather than the common infectious prodrome to heart failure. Severe leg swelling first lacks the infectious prodrome and is not characteristic of the typical initial course of myocarditis.