Is myocarditis nauseating?

Written by Zhou Yan
Geriatrics
Updated on April 12, 2025
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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 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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Criteria for Diagnosing Myocarditis

The diagnosis of myocarditis is primarily clinical, based on typical precursor symptoms, corresponding clinical manifestations, and physical signs. The precursor symptoms usually occur one to three weeks before the onset, including symptoms of a viral infection such as fever, general fatigue, and muscle soreness, or gastrointestinal symptoms like nausea and vomiting. Subsequently, symptoms such as chest tightness, palpitations, difficulty breathing, and even fainting and sudden death may occur. The physical signs generally include arrhythmias, commonly premature atrial contractions, premature ventricular contractions, or conduction blocks. There may be an increased heart rate which does not correspond to the body temperature, and there could be the presence of second or third heart sounds or gallop rhythm. A minority of patients may show signs of heart failure. Tests can include electrocardiograms, enzymatic studies, or echocardiograms, and magnetic resonance imaging may show symptoms of myocardial injury. To confirm the diagnosis, an endomyocardial biopsy must be performed.

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Written by Zhou Yan
Geriatrics
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What tests are done for myocarditis?

First is the electrocardiogram, which can show STT changes, including mild ST segment shift and T wave inversion, and various arrhythmias, especially ventricular arrhythmias and atrioventricular conduction blocks. Next is the cardiac ultrasound, also known as echocardiography, which can be normal or show left ventricular enlargement, reduced left ventricular motion, and decreased left ventricular systolic function. Another method is cardiac MRI, which mainly shows evidence of cardiac damage, and this has significant implications for the diagnosis of myocardial conditions. Additionally, biochemical tests include elevated cardiac enzymes, troponin, accelerated erythrocyte sedimentation rate, and other non-specific inflammatory markers. Moreover, there is cardiac biopsy, which is generally invasive and thus mainly used in patients with severe conditions, poor treatment response, or unknown causes. This test is generally not used in patients with mild symptoms. Other tests include chest X-rays and etiological examinations.

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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 Xiao Chang Jiang
Cardiology
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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.