Definition
Myocarditis is an inflammation of the heart’s wall. It is rare and can be very serious.
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Causes
The cause of myocarditis is not always known. Causes that are known are:
- Infectious—from bacteria, protozoa, viruses, or fungi
- Toxic—from medicines, or exposure to heavy metals, toxins, shock, or radiation
- Problems of the immune system—allergic reactions, heart transplant rejection, or autoimmune disease
Symptoms
Myocarditis may not cause symptoms. When symptoms happen, they may be:
- Flu-like symptoms—such as fever, tiredness, muscle pain, vomiting, loose stools (poop), and weakness
- Fast or uneven heartbeats
- Chest pain
- Leg swelling
- Problems breathing
- 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. Other causes of heart problems must be ruled out first.
The doctor will ask about symptoms and past health. A physical exam will be done. Tests may include:
- Blood tests—to look for signs of heart damage or infection
- ECG—to see the heart’s electrical activity
- Biopsy—a sample of heart tissue is removed for testing (rare)
Images of the heart may be taken with:
Treatment
The first line of treatment is support care. The goal is to manage symptoms and slow or prevent more damage. Care will often require a hospital stay.
When possible, the cause will be treated. For example:
- Antibiotics—for bacterial infections
- Antiviral medicine—for viral infections
- Medicines to adjust the immune system—for autoimmune disorders (such as systemic lupus erythematosus or scleroderma )
If heart failure is present, it may be treated with:
- Medicines to support the heart
- An implanted device to help pump blood—if other treatments do not help
- A heart transplant—for severe heart damage
Prevention
It is not possible to prevent all myocarditis. To lower the risk of infection that could lead to myocarditis:
- Wash hands often.
- Use latex condoms during sex.
- Do not use drugs for non-medical reasons.
For those with HIV, special antiviral therapy may help lower the risk of myocarditis.
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
Myocarditis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/myocarditis . Accessed September 6, 2021.
Myocarditis. Health—Johns Hopkins Medicine wesbite. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/myocarditis. Accessed September 6, 2021.
Tschöpe C, Ammirati E, et al. Myocarditis and inflammatory cardiomyopathy: current evidence and future directions. Nat Rev Cardiol. 2021;18(3):169-193.
Understand your risk for heart failure. American Heart Association website. Available at: https://www.heart.org/en/health-topics/heart-failure/causes-and-risks-for-heart-failure/understand-your-risk-for-heart-failure#.WiAtp1WnFQI. Accessed September 6, 2021.
Revision Information
- Reviewer: EBSCO Medical Review Board Nicole Meregian, PA
- Review Date: 07/2021
- Update Date: 09/06/2021