What are the symptoms of myocarditis?

Written by Tang Li
Cardiology
Updated on September 04, 2024
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The clinical manifestations of myocarditis in patients depend on the extent and location of the lesion. Mild cases may have no symptoms at all, while severe cases can even present with heart failure and shock. Most patients have precursor symptoms of viral infection one to three weeks before the onset, such as fever, general fatigue, and muscle soreness. Some patients have gastrointestinal symptoms like nausea and vomiting. Subsequently, they may experience palpitations, chest pain, breathing difficulties, edema, and even fainting or sudden death. The majority of clinically diagnosed myocarditis cases primarily present with or are primarily symptomatic of psychological frailty. A minority of patients may experience fainting or Aschner's syndrome as a result.

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Written by Zhou Yan
Geriatrics
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What are the symptoms of myocarditis?

Myocarditis is an inflammatory disease of the myocardium. The clinical manifestations of viral myocarditis in patients depend on the extent and location of the lesions. Mild cases may have no symptoms at all, while severe cases can lead to cardiogenic shock or even sudden death. Most patients may have prodromal symptoms of viral infection one to three weeks before onset, such as fever, general fatigue, muscle soreness, or gastrointestinal symptoms like nausea and vomiting. Subsequently, they may experience palpitations, chest tightness, difficulty breathing, edema, fainting, or sudden death.

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Written by Zhou Yan
Geriatrics
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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.)

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Written by Zhou Yan
Geriatrics
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How is myocarditis diagnosed?

Myocarditis is an inflammatory disease of the myocardium, which can be confirmed by the following tests: Chest X-rays can show an enlarged cardiac silhouette. Electrocardiograms can reveal changes in the ST-T segments, and various arrhythmias may also occur, especially ventricular arrhythmias and atrioventricular conduction blocks. Echocardiography might be normal, or it might show enlargement of the left ventricle and weakened wall motion. Cardiac MRI is of significant importance for the diagnosis of myocarditis, showing patchy enhancement of the myocardium. Biochemical blood tests can show elevated non-specific inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein, and elevated levels of myocardial enzymes and troponin. Serological testing for viruses can suggest a cause but is not definitive for diagnosis. Finally, endomyocardial biopsy, besides diagnosing, can also aid in assessing the condition and prognosis. However, it is invasive, so it is generally used only in urgent and severe cases, cases with poor treatment response, or in patients with undiagnosed causes. It is not commonly performed in patients with mild conditions.

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Written by Zhou Yan
Geriatrics
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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.

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Written by Zhou Yan
Geriatrics
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How is myocarditis diagnosed?

The examination of myocarditis includes several aspects: First, the biochemical blood test shows that white blood cells can increase, erythrocyte sedimentation rate can accelerate, and both cardiac enzymes and troponins can rise. There may also be abnormalities in the electrocardiogram, such as arrhythmias or ST-segment changes. In addition, there are X-ray examinations, which can show an enlarged heart shadow or pulmonary congestion. Echocardiograms may not show any specific changes or can exhibit phase-dependent or regional abnormalities in ventricular wall motion. Furthermore, nuclear imaging and magnetic resonance imaging indicate the presence of fluttering and inflammatory changes. The virological examination can isolate the virus through throat swabs or stool samples, and if necessary, an endocardial or myocardial biopsy can be performed.