Difference between myocarditis and myocardial injury

Written by Tao Kun
Geriatrics
Updated on September 05, 2024
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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.

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Written by Xiao Chang Jiang
Cardiology
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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.

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Written by Chen Si
Pediatrics
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Is pediatric myocarditis serious?

The severity of myocarditis in children needs to be assessed by considering the child's clinical symptoms and corresponding clinical examinations comprehensively. Common clinical symptoms include chest tightness, fatigue, shortness of breath, etc. Most children have a history of upper respiratory tract infection before the symptoms appear. It is necessary to conduct routine blood tests, myocardial enzymes, troponin, myocardial antibodies, viral antibodies, electrocardiograms, and other relevant physicochemical examinations to further clarify the condition. Patients with mild symptoms and roughly normal laboratory results can improve on their own with rest. If there are clinical symptoms such as chest tightness, fatigue, shortness of breath, and related physicochemical examinations show abnormal changes, it is necessary to use medication to nourish the myocardium. During treatment, rest is advised, reduce fatigue, maintain emotional stability, and generally, the symptoms can improve within 10 to 15 days. For more severe cases, the treatment period may need to be extended accordingly.

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Written by Zhou Yan
Geriatrics
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Is myocarditis nauseating?

For patients with myocarditis, they may experience palpitations, chest tightness, difficulty breathing, various arrhythmias, and edema, and even fainting or sudden death. If the diagnosis of myocarditis includes these conditions, one to three weeks prior to the onset, the patient might have symptoms of viral infections, such as nausea, vomiting, and other gastrointestinal symptoms, or may have fever, general fatigue, muscle soreness, and other discomforts. However, not all cases of myocarditis will have symptoms of nausea, and nausea is not necessarily indicative of myocarditis, therefore there is no inevitable link between the two.

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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 Tang Li
Cardiology
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What are the symptoms of myocarditis?

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.