What is myocarditis, and how does it affect you? Symptoms Treatment
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)
•
fever
Children and infants with myocarditis have more vague symptoms:
•
Headache
•
Poor appetite
•
Abdominal pain
•
Cough that is
persistent
•
Breathing
problems are getting worse.
•
Fever
•
Rash
•
Diarrhea
•
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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