How is myocarditis diagnosed?

Written by Zhou Yan
Geriatrics
Updated on March 13, 2025
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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.

Other Voices

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Written by Xiao Chang Jiang
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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.

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Written by Zhou Yan
Geriatrics
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Can myocarditis heal itself?

Myocarditis is an inflammatory disease of the myocardium. Common causes include viral infections, while bacterial and fungal infections can also cause myocarditis, but these are relatively less common. The onset of myocarditis can vary; it may be rapid, occasionally leading to acute heart failure and sudden cardiac death. However, most cases of myocarditis are self-limiting, though they can also progress to dilated cardiomyopathy. For individuals presenting with flu-like symptoms such as fever, general fatigue, muscle soreness, nausea, and vomiting, or other gastrointestinal issues, it is advisable to provide rest and nutritional support treatment. This is because these cold symptoms might also be indicative of myocarditis. Therefore, general treatment, rest, and nutrition should be emphasized for patients with colds.

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Written by Di Zhi Yong
Cardiology
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How to relieve myocarditis pain?

If a patient is diagnosed with myocarditis, especially viral myocarditis, and experiences chest pain, some analgesic medications can be used, particularly non-steroidal anti-inflammatory drugs (NSAIDs). If the patient has infective endocarditis or other forms of myocarditis, it is not recommended to use pain-relieving medications due to individual differences, as this may exacerbate symptoms and mask the true condition. For general cases of myocarditis, it is sufficient to use some common NSAIDs. However, it is still important to actively treat the primary disease, control the patient's symptoms, and initially use antiviral medications predominantly, which can also alleviate symptoms. Regular echocardiogram reviews to monitor changes are also necessary.

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Written by Zhou Yan
Geriatrics
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Can people with myocarditis drink alcohol?

Myocarditis is an inflammatory disease of the myocardium. Its pathogenesis is due to direct damage to the myocardium caused by viruses, and the interaction of the virus with the body's immune response to both myocardial injury and microvascular damage, which impairs the structure and function of the myocardial tissue. Drinking alcohol affects the myocardium and can also cause damage to it. Therefore, alcohol should not be consumed with myocarditis, as drinking can further aggravate the myocardium, leading to heart failure.

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Written by Zhou Yan
Geriatrics
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The dangers of myocarditis

Myocarditis is an inflammatory disease of the myocardium. Most cases of myocarditis are self-limiting, but if not treated promptly, it can progress to dilated cardiomyopathy. Dilated cardiomyopathy often begins insidiously. Once symptoms appear and the patient enters the stage of heart failure, the condition becomes very serious. Additionally, a minority of patients experience a fulminant onset, leading to acute decompensation or sudden death. Fulminant myocarditis and severe myocarditis progress quickly and have a high mortality rate, thus highlighting the dangers of myocarditis.