What is myocarditis, and how does it affect you?

Inflammation of the heart muscle is known as myocarditis (myocardium). Inflammation of the heart muscle causes heart muscle cells to degenerate or die. Myocarditis can be caused by a variety of factors and can range in severity from moderate (resolving quickly) to rapidly advancing deadly diseases. Pericarditis differs from myocarditis in that pericarditis is an inflammation of the sac that surrounds the heart and does not damage the heart muscle. It is not uncommon, however, for a patient to have both pericarditis and myocarditis.

There are numerous different forms of myocarditis, as well as a variety of different substances that might cause it.

Here are several examples:

            Viruses such as Coxsackie B, enterovirus, adenovirus, influenza, and others

            Streptococci, meningococci, clostridia, Corynebacterium, mycobacteria, and a variety of other microorganisms

            Candida, Aspergillosis, Cryptococcus, Schistosomes, Filaria, Malaria, Toxoplasma, and a variety of other fungi and parasites

            Lymphocytic: Lymphocytes penetrate the heart muscle.

            Eosinophilic: Eosinophils invade the heart muscle

            Autoimmune: Caused by autoimmune illnesses like lupus

            Fulminant: Inflammation of the heart muscle that leads to immediate catastrophic heart failure

            Idiopathic: An inflammation of the heart muscle that has no known etiology.

            Acute: Symptoms begin suddenly and subside within a week or two.

            Chronic: Symptoms that appear slowly and stay longer than two weeks.

What is the cause of myocarditis?

The following are some of the myocardium-damaging agents:

            Infectious agents such as viruses, bacteria, fungus, and/or parasites have cytotoxic effects.

            Infectious agent-induced immune response, as well as cytokines generated in the myocardium in response to infection or inflammation

            Chemicals released during myocardial cell death

            Autoimmune responses can also cause myocardial inflammation

            Medications and/or toxins such as clozapine, radiation therapy, arsenic, carbon monoxide, and others can cause myocardial inflammation.

            Lupus, Wegener's granulomatosis, and other autoimmune disorders

The triggering cause for myocardial inflammation is unknown about half of the time (idiopathic). This is especially true in the pediatric population, where idiopathic myocarditis is the most common diagnosis.

What signs and symptoms do you have if you have myocarditis?

Myocarditis is a condition that might be mild and have few symptoms. The most common symptom of myocarditis is chest discomfort. Other signs and symptoms are linked to the underlying cause, such as an infection or an autoimmune illness. The following is a list of myocarditis symptoms and signs:

            Shortness of breath

            Chest pain or discomfort

            Edema and/or swelling

            Liver congestion

            Palpitations (abnormal heartbeat)

            Sudden death (in young adults)



Children and infants with myocarditis have more vague symptoms:



            Poor appetite

            Abdominal pain

            Cough that is persistent

            Breathing problems are getting worse.




            Joint discomfort


When Should You Contact Your Doctor?

If you develop symptoms of myocarditis, call your doctor right once. It's more likely that you have the condition if you've had or had an infection. If your symptoms are severe, seek medical help right once. Call 911 or go to the hospital if your chest discomfort, breathing problems, or swelling have worsened after you were diagnosed with myocarditis.

How can you know if you have myocarditis?

During the patient's history and physical exam, symptoms of irritation of the heart muscle are detected and myocarditis is identified. CPK levels (heart muscle enzymes) can be high in blood testing. Electrical testing (EKG) can reveal inflammation of the heart muscle as well as irregular heartbeat. Nuclear heart scans can reveal irregular heart muscle regions. Chest X-rays to establish the size and form of the heart, MRI, and echocardiogram are further tests that can assist in clearly diagnosing myocarditis. To diagnose the likely underlying etiology of the disease, cardiac catheterizations with heart muscle biopsy (endomyocardial biopsy) may be performed.

What is the best way to treat myocarditis?

Myocarditis frequently improves without treatment and leads to full recovery. Treatment of the underlying cause (such as bacterial infections) can sometimes result in full recovery (for example, after antibiotics). As a result, determining the precise underlying cause of myocarditis can aid in selecting the best treatment option.

Patients with more severe or persistent myocarditis, on the other hand, may require more specialized treatments or possibly hospitalization. Medications that lessen the workload of the heart and/or minimize edema are widely used to treat myocarditis symptoms. They could consist of the following:

            Vasotec (enalapril)

            Captopril (Capoten)

            Lisinopril (Zestril, Prinivil)

            Ramipril is a drug used to treat high blood pressure (Altace)

            Metoprolol is a drug that is used to treat high blood pressure (Lopressor)

            Carvedilol is a kind of carvedilol (Coreg)

            Furosemide is a diuretic (Lasix)

Individuals with severe myocarditis symptoms (heart failure, shortness of breath) may require additional therapies such as intravenous medicines, vascular assist devices (a pump that helps a weak heart pump), or extracorporeal membrane oxygenation (ECMO) to help supply oxygen to the blood. Patients may require a heart transplant on occasion. . Individuals with severely irregular heartbeats (arrhythmias) may require a pacemaker implant.

What is the prognosis (prognosis) for myocarditis patients?

Patients with acute myocarditis who recover quickly have a fairly good prognosis. Even patients with severe myocarditis can recover entirely with only a little or no problems. However, if the cardiac muscle damage becomes chronic and/or progressive, the patient's prognosis will deteriorate. The prognosis is worse for those who acquire significant cardiac muscle cardiomyopathy.


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