Myocarditis
The term myocarditis refers to any inflammatory condition affecting the heart muscle, regardless of cause. Inflammatory conditions may be caused by viruses or bacteria, but may also be caused by the effects of certain poisons and medicines. In its severest form, myocarditis can lead to acute cardiac failure.
What is myocarditis?
Myocarditis is an inflammation of the heart muscle. While most cases of myocarditis are caused by a viral infection, other causes include bacteria, fungi, parasites and other microorganisms. Myocarditis can also be caused by certain poisons such as alcohol and heavy metals, as well as certain medicines, in particular anticancer drugs. Over the course of the disease, there may be a marked decrease in the heart's ability to pump blood around the body, which may lead to acute heart failure.
Treatment involves the administration of medication to relieve the strain on the heart, as well as avoidance of strenuous physical activity. Only in rare cases will a patient require surgery or even a heart transplant.
What are the main symptoms?
- Shortness of breath
- Palpitations (racing heart)
- Chest pain
- Fatigue
- Irregular heartbeat
- Fever
What are possible causes?
- Viruses such as the coxsackie virus, flu virus and mumps virus
- Bacteria, fungi and other microorganisms
- Poisons such as heavy metals or alcohol
- Medicines such as anticancer or psychotropic drugs
- Autoimmune diseases such as sarcoidosis and scleroderma
Diagnosis of myocarditis
- Medical history and physical examination to ascertain if there is any evidence to support first suspicions
- ECG, but changes are usually too non-specific
- Blood tests - at the acute stage, blood tests may confirm an increase in cardiac enzymes and markers of inflammation.
- Echocardiography - this may provide evidence of a potential enlargement of the ventricles, and a reduction in the ability of the heart to pump blood around the body.
- Cardiac catheterization - to exclude the presence of restrictions in coronary artery blood flow
- In rare cases, a small tissue sample may be taken from the heart muscle. This can help to confirm the diagnosis, as well as helping to identify certain types of viruses found inside the tissue. This may allow physicians to develop a treatment approach that is directly targeted at the underlying virus infection.
Treatment for myocarditis
- Avoidance of strenuous physical activity, monitoring
- Medication to support the heart
- Treatment targeted at the underlying condition, if known; this applies to certain viral infections
- In many cases, improvements in cardiac function can be seen in a matter of months. If heart function remains impaired for longer, the condition is considered chronic. Depending on the severity of the condition and the exact combination of symptoms present, the treatment approach may then need to be adapted to include additional measures to deal with the symptoms of heart failure.
