Definition
Myocarditis is an inflammation of the heart’s wall. It is rare and can be very serious. For some it may not cause symptoms.
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Causes
The cause is not always known. Causes that are known fall into one of the following categories:
- Infectious—bacterial, viral, or fungal
- Toxic—medications, or exposure to heavy metals, toxins, shock, or radiation
- Problems of immune system—allergic reactions, heart transplant rejection, or autoimmune disorders
Symptoms
Myocarditis may not cause symptoms. Those that do appear are related to the cause and severity. Symptoms may build slowly or come on fast. Some common symptoms include:
- Flu-like complaints, including fever, fatigue, muscle pain, vomiting, diarrhea , and weakness
- Rapid or irregular heart rate
- Chest pain
- Shortness of breath and respiratory distress
- Loss of consciousness
- Sudden, unexpected death
Myocarditis can lead to heart failure .
Diagnosis
It can be hard to diagnosis myocarditis. There is no specific test for it. Many other causes of heart problems must be ruled out first.
Your doctor will ask about your symptoms and health history. A physical exam will be done. Tests may include:
- Blood tests to look for signs of heart distress or infection
- ECG —shows heart’s electrical activity
- Biopsy —sample of heart tissue is removed for testing
Tests will let the doctor get images of the heart include:
Treatment
The first line of treatment is support care. A care plan will help to manage your symptoms and sow or prevent further damage. Care will often require a hospital stay.
When possible the cause will be treated. For example:
- Bacterial infection—antibiotics
- Viral infection—antiviral medicine
- Autoimmune disorder (such as systemic lupus erythematosus or scleroderma )—immunosuppressive therapy
Medicine can help to support the heart if heart failure is present. These include:
- Diuretics
- Angiotensin-converting enzyme (ACE) inhibitors
- Beta-blockers
Severe heart damage may require a cardiac transplant. A donor heart will replace the damaged heart.
Prevention
It is not possible to avoid all myocarditis. To decrease risk of infection that could lead to myocarditis:
- Wash your hands often.
- Use latex condoms during sex.
- Do not use drugs for non-medical reasons.
RESOURCES
American Heart Association http://www.heart.org
National Heart, Lung, and Blood Institute https://www.nhlbi.nih.gov
CANADIAN RESOURCES
Health Canada https://www.canada.ca
Heart and Stroke Foundation of Canada http://www.heartandstroke.ca
References
Brady WJ, Ferguson JD, et al. Myocarditis: emergency department recognition and management. merg Med Clin North Am. 2004;22(4):865-885.
Causes and risks of heart failure. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartFailure/UnderstandYourRiskforHeartFailure/Understand-Your-Risk-for-Heart-Failure%5FUCM%5F002046%5FArticle.jsp#.WiAtp1WnFQI. Updated May 8, 2017. Accessed November 30, 2017.
Feldman AM, McNamara D. Myocarditis. N Engl J Med. 2000;343(19):1388-1398.
Felker GM, Thompson R, Hare JM et al. Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy. N Engl J Med. 2000;342(15):1077-1084.
Myocarditis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114167/Myocarditis . Updated September 5, 2017. Accessed November 30, 2017.
Revision Information
- Reviewer: EBSCO Medical Review Board Michael J. Fucci, DO, FACC
- Review Date: 11/2018
- Update Date: 08/22/2018