Is myocarditis serious?

Written by Zhou Yan
Geriatrics
Updated on February 02, 2025
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Myocarditis is an inflammatory disease of the myocardium, most commonly caused by viral infections. The onset of the disease can be either sudden or slow, and it is mostly self-limiting, but in rare cases can lead to acute pump failure or sudden death. The severity of the condition largely depends 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. In clinical diagnosis, the majority of myocarditis cases present primarily with arrhythmias, and in a minority of cases, the initial symptoms may include syncope or Adams-Stokes syndrome. Thus, the severity of myocarditis is related to the variation in the condition itself.

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Does myocarditis require hospitalization?

Myocarditis is an infectious disease caused by viral infection leading to myocardial damage. Particularly extensive myocardial damage can pose significant risks to life and cause serious complications. Common complications include heart failure and arrhythmias, with severe cases possibly leading to sudden death. Therefore, patients with myocarditis must be hospitalized for treatment. Under the observation of doctors and nurses, effective rest can be ensured, and treatments such as antiviral and myocardial nutrition can be applied to prevent the occurrence of complications.

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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.

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Early manifestations of myocarditis

What are the early symptoms of myocarditis? In fact, most patients with myocarditis typically exhibit acute onset of symptoms, which generally occur 1 to 3 weeks after cardiac involvement, or they may simultaneously exhibit various degrees of viral infection symptoms such as fever, sore throat, cough, general malaise, muscle pain, skin rash, or nausea and vomiting, abdominal pain, and diarrhea. These are its prodromal symptoms. Additionally, some patients exhibit systemic viral infection symptoms when the disease occurs, such as rubella, measles, epidemic mumps, viral hepatitis, and other diseases. Since the recovery rate of myocarditis in the acute and recovery phases is significantly higher than in the lingering or chronic phases, it is evident that treatment for myocarditis should be initiated as early as possible to increase the recovery rate.

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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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Is myocarditis cough severe?

Patients with myocarditis often exhibit early symptoms such as fever, cough, difficulty breathing, fatigue, and in severe cases, chest tightness and shortness of breath, even leading to shock or death, and syncope. Typically, the cough is not too severe, but if myocarditis is suspected, the patient should go to the hospital for timely diagnosis. Primary diagnostic tests include electrocardiogram, myocardial enzymes, and cardiac ultrasound. Once diagnosed, hospitalization for immediate treatment is necessary to prevent the condition from worsening. Because fulminant myocarditis can lead to death within days from minor symptoms, all myocarditis patients should be treated as severe cases and not be neglected.