Description

Myocarditis is the inflammation of the heart muscle, called the myocardium. The condition can reduce the heart's ability to pump blood. Myocarditis can cause chest pain, shortness of breath, and fast or irregular heartbeat.

Infection with a virus is one of the causes of myocarditis. Sometimes myocarditis is caused by a drug reaction or a condition that causes inflammation throughout the body.

Severe myocarditis weakens the heart, so that the rest of the body do not receive enough blood. Clots may form in the heart, leading to a stroke or heart attack.

The treatment of myocarditis may include medications, procedures, or surgeries.

Symptoms

Some people with early myocarditis do not have symptoms. Others have mild symptoms.

Common myocarditis symptoms include:

  • Pain in the chest.
  • Fatigue.
  • Swelling of legs, ankles and feet.
  • Rapid or irregular heartbeats, called arrhythmias.
  • Shortness of breath at rest or during activity.
  • Dizziness or feeling like you might faint.
  • Flu-like symptoms such as headache, body aches, joint pain, fever, or sore throat.

Sometimes, myocarditis symptoms are like the symptoms of a heart attack. If you are having unexplained chest pain and difficulty breathing, seek emergency medical attention.

Myocarditis in children

When the children come to myocarditis, symptoms may include:

  • Difficulty breathing.
  • Rapid breathing.
  • Pain in the chest.
  • Rapid or irregular heartbeats, called arrhythmias.
  • Fainting.
  • Fever.

When to see a doctor

Contact with a health care professional if you have symptoms of myocarditis. The symptoms of myocarditis may seem like a heart attack. Get emergency medical help if you have pain, chest pain, fast heartbeat or shortness of breath.

If you have severe symptoms, go to the emergency room or call for emergency medical help.

Causes

Infections can cause myocarditis.

  • Virus.Many of the viruses have been linked to myocarditis, including adenovirus, which causes the common cold; theCOVID-19virus; the viruses that cause hepatitis B and C, parvovirus, which causes a mild rash, usually in children; and the herpes simplex virus. Gastro-intestinal infections due to echoviruses, Epstein-Barr virus, which causes mononucleosis, and German measles, also called rubeola, can all cause myocarditis. Myocarditis may also be caused byHIV, the virus that causesAIDS.
  • Bacteria. The bacteria that can cause myocarditis are staphylococcus, streptococcus, and the bacteria that cause diphtheria and Lyme disease.
  • Parasites. Parasites that can cause myocarditis, Trypanosoma cruzi and toxoplasma. Some parasites are transmitted by insects and can cause a condition called Chagas disease. Chagas disease is much more common in Central and South America than in the united States.
  • Fungi. A fungal infection can cause myocarditis, particularly in people with weakened immune systems. Fungal infections linked to myocarditis include fungal infections, such as candida; moulds, such as aspergillus; and histoplasma, are often found in the feces of the birds.

Virus. Many of the viruses have been linked to myocarditis, including adenovirus, which causes the common cold; the COVID-19 virus, the viruses that cause hepatitis B and C, parvovirus, which causes a mild rash, usually in children; and the herpes simplex virus.

Gastro-intestinal infections due to echoviruses, Epstein-Barr virus, which causes mononucleosis, and German measles, also called rubeola, can all cause myocarditis. Myocarditis may also be caused by HIV , the virus that causes AIDS .

Myocarditis may also be caused by:

  • Certain prescription or illegal drugs. These include medicines used to treat cancer; antibiotics, such as penicillin and sulfonamides; some anti-epileptic drugs; and the cocaine. When these cause myocarditis, it is called drug-induced myocarditis.
  • Chemicals or radiation. Exposure to carbon monoxide and radiation can sometimes cause myocarditis.
  • Other health conditions. Conditions that may cause myocarditis, which include lupus, Wegener's granulomatosis, giant cell arteritis and takayasu arteritis.

Often, the cause of myocarditis is not found.

Complications

Generally, myocarditis, disappears without complications. However, severe myocarditis may cause permanent damage to the heart muscle.

The possible complications of myocarditis may include:

  • Heart failure. This is not, myocarditis can cause damage to the heart muscle so that it can't pump blood well. People with myocarditis associated with heart failure may require a ventricular assist device or heart transplantation.
  • Heart attack or a stroke. If the heart muscle is damaged and can't pump blood, the blood that accumulates in the heart, clots can form. A heart attack can occur if a blood clot that blocks one of the arteries of the heart. A stroke can occur if a blood clot in the heart travels to one of the arteries leading to the brain.
  • Rapid or irregular heartbeats, called arrhythmias. The damage to the heart muscle can change the way the heart beats. Certain arrhythmias increase the risk of stroke.
  • The sudden cardiac death. Certain serious irregular heartbeats can cause the heart to suddenly stop beating, a condition called sudden cardiac arrest. If it leads to death is called sudden cardiac death.

Prevention

There is No specific prevention for myocarditis. However, taking these steps to prevent the infection may help:

  • Stay away from sick people. Stay away from people with symptoms of the flu or other diseases of the respiratory tract until they feel better. If you are sick with symptoms of a viral infection, try to avoid passing germs to others.
  • Wash your hands regularly. Frequent hand-washing is one of the best ways to not get sick and spread germs.
  • Avoid risky behaviors. To reduce the chances of getting HIV -related infection of the myocardium, the practice of safe sex and not use illegal drugs.
  • Get the recommended vaccines. Stay up to date with recommended vaccines, including those that protect against COVID-19 , influenza, and rubella vaccination, diseases that can cause myocarditis. Rarely, the COVID-19 vaccine can cause myocarditis and inflammation of the outer lining of the heart, called pericarditis, especially in men between the ages of 12 to 29 years old. Talk with your health care team about the benefits and risks of vaccines.

Diagnosis

The early diagnosis of myocarditis is important to prevent long-term heart damage. To diagnose myocarditis, a health care professional examines and listen to your heart with a stethoscope.

Blood and imaging tests may be done to check the health of your heart. Imaging tests can help to confirm the myocarditis and determine its severity.

Tests

Tests to diagnose myocarditis are:

  • Blood tests. Blood tests are usually performed to check for a heart attack, inflammation, and infection. A cardiac enzyme test can check for proteins related to the damage of the heart muscle. Antibody blood tests may help you to know if you have had an infection linked to myocarditis.
  • Electrocardiogram (ECG or EKG). This quick and painless test shows how the heart is beating. Your health care professional may look for patterns of signals in an ECG to find out if you have an irregular heartbeat.
  • X-ray of the chest. A chest x-ray shows the size and shape of the heart and lungs. A chest x-ray can tell if there is fluid in or around the heart that it could be related to heart failure.
  • Magnetic resonance imaging of the heart, also called cardiacMRI. This test uses magnetic fields and radio waves to create detailed pictures of the heart. A cardiac mri shows the heart's size, shape, and structure. It can help in the diagnosis of myocarditis.
  • The echocardiogram. Sound waves to create moving images of the beating heart. An echocardiogram can show the heart's size and how well the blood flows through the heart and heart valves. An echocardiogram can see if there is fluid around the heart.
  • Catheterization of the heart, and the heart of the muscle biopsy. A doctor places a thin, flexible tube called a catheter into a blood vessel in the arm or in the groin. It is guided to an artery in the heart. Contrast dye flows through the catheter to help the arteries of the heart are shown more clearly on x-rays. A small sample of heart muscle tissue can be taken during this test. This is called a biopsy. The sample is sent to a laboratory to determine the presence of signs of myocarditis or an infection.

Treatment

Often, myocarditis, it gets better on its own or with treatment. The myocarditis treatment focuses on the cause and symptoms, such as heart failure.

The myocarditis treatment may include:

  • Of medicine.
  • Medical devices.
  • Surgery.

Drugs

People with a mild degree of myocarditis may only need rest and medicine. If myocarditis is severe, medications may be given through an IV in a hospital to quickly improve the heart's ability to pump blood.

Medicine for the treatment of myocarditis may include:

  • Corticosteroids. These medications may be used to treat some rare types of viral myocarditis, such as giant cells and myocarditis, eosinophilic.
  • Medicines to prevent blood clots. If myocarditis is causing severe congestive heart failure or irregular heartbeat, may be given medication to reduce the risk of blood clots in the heart.
  • Drugs for the heart. Medications can be used to remove excess fluid from the body and to reduce the strain on the heart. Some types of medications that can be used for the treatment of myocarditis symptoms are diuretics, beta-blockers, inhibitors of the angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin 2 receptor blockers (Arbs).
  • Medications for the treatment of chronic conditions. Sometimes another health condition, such as lupus, the cause of the myocarditis. The treatment of the underlying condition can help to reduce the inflammation of the myocardium.

Some people with myocarditis to take medications for a few months and then get a better completely. Others may have long-term heart damage that needs throughout the life of the medicine. It is important to have regular health exams after myocarditis to check for possible complications.

Therapies

A treatment called extracorporeal membrane oxygenation (ECMO) can be used to help the heart to recover, or while waiting for other treatments, such as a heart transplant.

An ECMO machine works such as the lungs. Removes carbon dioxide and adds oxygen to the blood. If you have severe heart failure, this device can send oxygen to your body. During ECMO , blood is removed from the body through the tube, it passes through the machine, and then returned to the body.

Surgeries and procedures

Severe myocarditis needs aggressive treatment. Treatment may include:

  • Ventricular assist device (VAD). A lack of vitamin a that helps pump blood from the lower chambers of the heart to the rest of the body. It is a treatment for a weak heart or heart failure. Open heart surgery is usually necessary to place the device in the body. The device can be used to help the heart work while waiting for other treatments, such as a heart transplant.
  • Intra-aortic balloon pump (IABP). This device helps to increase the blood flow and reduce the pressure on the heart. It is placed in the main artery of the body, called the aorta. A doctor inserts a thin tube called a catheter into a blood vessel of the leg and the leads to the aorta. A ball on the end of the catheter is inflated and deflated as the heart beats and relaxes.
  • Heart transplant. An urgent heart transplant may be necessary for those who have very severe myocarditis.

Lifestyle and home remedies

The rest and the reduction of the strain on the heart are important parts of the myocarditis of recovery.

If you have or have had myocarditis, ask your health care professional which type and amount of physical activity is safe for you. If you have myocarditis, you should avoid competitive sports for at least 3 to 6 months.

Preparing for your appointment

If you have symptoms of myocarditis, make an appointment for a health checkup. If the symptoms are severe, it may be seen in a context of emergency. Usually they are sent to a medical doctor trained in diseases of the heart, called a cardiologist. You can also see a physician trained in infectious diseases.

What you can do

Here's some information to help you prepare for your appointment. Write down the following data:

  • Your symptoms, including any that may seem unrelated to myocarditis, and when they began.
  • Important personal information, including recent illnesses and symptoms, recent travel locations, and your and your family's medical history.
  • All the drugs, vitamins, and supplements you are taking. Including those bought without a prescription. Also include the dose.
  • Questions to ask your health care team.

For myocarditis, basic questions to ask your health care team include:

  • What is the most likely cause of my symptoms?
  • What are other possible causes?
  • What tests do I need?
  • How is the myocarditis is this?
  • What side effects can I expect from treatment?
  • There are alternatives to the primary treatment that you are suggesting?
  • I have other health conditions. How can I best manage these conditions?
  • I need to change my activities or the diet?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Do not hesitate to ask other questions. Have a friend or family member along to your appointment, if possible, to help you remember the information that you receive.

What to expect from your doctor

Your health care team is likely that many questions, including:

  • Have you recently been sick or have recovered from another disease?
  • You have recently traveled out of the country?
  • What, if anything, makes the symptoms better?
  • What, in any case, it makes your symptoms worse?
Symptoms and treatment of Myocarditis