Subscribe
Myocarditis
Causes of Myocarditis
Myocarditis is also an inflammatory disease of the myocardium. Common causes are viral infections, such as Coxsackievirus B, Parvovirus B19, Human Herpesvirus 6, and Poliovirus, with Coxsackievirus B being the most common cause, accounting for about 30%-50%. Bacteria, fungi, spirochetes, rickettsiae, and protozoa can also cause myocarditis, but they are relatively rare. Non-infectious causes of myocarditis include drugs, radiation, connective tissue diseases, vasculitis, giant cell myocarditis, among others. These are all causes of myocarditis.
Is myocarditis serious?
Is myocarditis serious? In fact, myocarditis is an inflammatory disease of the myocardium. Patients with myocarditis may experience symptoms such as fatigue, palpitations, shortness of breath, discomfort or pain in the precordial area, nausea, vomiting, abdominal pain, diarrhea, etc. During examinations, we often see slight enlargement of the heart, arrhythmias, gallop rhythm, and other manifestations of heart dysfunction. In severe cases, myocarditis can lead to fulminant myocarditis, such as severe heart failure or cardiogenic shock, often accompanied by arrhythmias. Even with timely and standard treatment, death may occur due to the severity of the condition. Even if patients with myocarditis recover, they may still have some sequelae on the electrocardiogram, such as atrioventricular block, bundle branch block, premature beats, or junctional rhythm.
How is myocarditis treated?
Let's talk about how myocarditis is treated. Myocarditis is actually considered a self-limiting disease with no specific cure. However, treatment generally revolves around symptomatic treatment, combining conventional care and symptom management. For general treatment, bed rest is highly recommended for patients suffering from acute viral myocarditis to reduce the strain on the heart. Patients suffering from severe arrhythmias or heart failure are advised to rest in bed for at least one month and are not allowed to participate in strenuous physical labor for six months. For those without cardiac morphological or functional changes, rest for half a month is recommended, followed by avoiding heavy physical activity for three months. Additional antiviral treatments, such as interferon-alpha and Astragalus membranaceus, may be used; protective cardiac therapies or immunotherapies may also be administered. Symptomatic treatment mainly targets patients with severe heart failure or severe arrhythmias, following conventional treatment protocols for these conditions. For patients with complete atrioventricular block, temporary pacemakers may be used, and permanent pacemakers can be installed depending on the situation if the block cannot be resolved. Depending on the type of arrhythmia, antiarrhythmic medications like beta-blockers, amiodarone, and others may also be used. As each patient's cause of illness, severity, and physical constitution vary, it is essential to undergo personalized treatment under the guidance of a doctor.
Does myocarditis cause a fever?
Myocarditis is an inflammatory heart disease, commonly caused by viral infections, with the Coxsackievirus being the most common. Other infections, such as bacterial, fungal, and Rickettsia, can also cause myocarditis. These infectious myocarditis cases generally show preliminary symptoms of infection, such as fever, in the 1 to 3 weeks before the onset of the disease. Fever indicates a high body temperature, which means the same as having a fever. However, there are also non-infectious forms of myocarditis, such as those caused by drugs, radiation, or connective tissue diseases, and these non-infectious types of myocarditis do not always involve a fever.
Manifestations of myocarditis
Myocarditis is an inflammatory disease of the myocardium. Its manifestations depend on the extent and location of the condition; mild cases may have no symptoms, while severe cases can lead to cardiogenic shock and sudden death. Most patients experience precursor symptoms of viral infection one to three weeks before onset, such as fever, general fatigue, and muscle soreness, or gastrointestinal symptoms like nausea and vomiting. Subsequently, they may experience palpitations, chest tightness, difficulty breathing, and potentially fainting or sudden death. Clinically diagnosed myocarditis is mostly due to arrhythmias as the primary complaint, or patients seek treatment for common symptoms.
Obvious symptoms of myocarditis
Myocarditis refers to the inflammatory disease of the myocardium, with viral infection being the most common cause. Therefore, the majority of patients exhibit precursor symptoms of a viral infection one to three weeks before onset, such as fever, general fatigue, muscle soreness, or gastrointestinal symptoms like nausea and vomiting. This may be followed by palpitations, chest discomfort, chest pain, difficulty breathing, edema, and even fainting or sudden death. In the clinical diagnosis of myocarditis, the majority of cases initially present with symptoms of arrhythmias such as palpitations or a racing heart, but a minority may also experience fainting or Adams-Stokes syndrome (also known as cardiogenic cerebral ischemia).
How is myocarditis detected?
The diagnosis of myocarditis includes several aspects: The electrocardiogram may show STT changes, or various arrhythmias. Chest radiography may reveal an enlarged cardiac silhouette, while an echocardiogram may be normal or show left ventricular enlargement. Magnetic resonance imaging may show myocardial edema or congestion. Biochemical examinations may reveal elevated levels of troponin and myocardial enzymes, as well as increased erythrocyte sedimentation rate and C-reactive protein. Additional diagnostic methods include etiological examinations, which can identify viral infections through blood or stool samples. Furthermore, endocarditis or myocardial biopsy can provide definitive diagnosis.
How is myocarditis cured?
Myocarditis often has a self-limiting course, and viral infection is a common cause of myocarditis. Currently, there is no specific treatment for viral myocarditis. Treatments are divided into two main categories: general treatment, primarily consisting of rest. Generally, patients should rest in bed for more than three months, while also paying attention to their diet by eating easily digestible foods rich in vitamins and proteins. The second category is drug treatment, which mainly supports heart function. In cases of heart failure, diuretics, vasodilators, and ACE inhibitors should be administered. For arrhythmias, anti-arrhythmic treatment is necessary. If viral myocarditis is confirmed, antiviral treatment should be given. Additionally, drugs that enhance myocardial metabolism, such as cyclic adenosine monophosphate, coenzyme A, or adenosine triphosphate, should also be used. (Specific medication use should be conducted under the guidance of a doctor.)
Is myocarditis contagious?
Many people often ask if my myocarditis is contagious. Actually, myocarditis is a focal inflammatory lesion of the myocardium or a diffuse inflammatory disease of the entire myocardium. It is an inflammatory disease of the myocardium. Based on the cause, we classify it into infectious and non-infectious types. The infectious type is mostly caused by viruses, such as Coxsackievirus B, or by bacteria, while non-infectious type is caused by allergies. Generally, they are not contagious.
Difference between myocarditis and myocardial injury
Myocarditis is inflammation of the myocardial cells caused by a virus that has not been timely cleared following a respiratory or gastrointestinal viral infection. It is a term used for disease diagnosis. Myocardial injury, on the other hand, refers to the necrosis of myocardial cells due to various factors, including viral myocarditis and myocardial ischemia caused by the narrowing of coronary arteries. Therefore, myocardial injury is a state diagnosis, not a term used for disease diagnosis. Myocardial injury usually leads to elevated levels of troponin.