Myocarditis

Myocarditis is an inflammation of the heart muscle.

Alternative Names

Inflammation - heart muscle; Cardiomyopathy

Causes, incidence, and risk factors

Myocarditis is an uncommon disorder caused by viral infections such as coxsackie virus, adenovirus, and echovirus. It may also occur during or after various viral, bacterial, or parasitic infections (such as polio , influenza , or rubella ). The condition may be caused by exposure to chemicals or allergic reactions to certain medications and it can be associated with autoimmune diseases. The heart muscle becomes inflamed and weakened, causing symptoms of heart failure, which may mimic a heart attack.

Signs and tests

A physical examination may detect a rapid heartbeat ( tachycardia ) or abnormal heart beats, abnormal heart sounds (murmurs, extra heart sounds), fluid in the lungs and fluid in the skin of the legs. In addition, other signs suggestive of an infection may be present: fever, rashes, red throat, itchy eyes, swollen joints. Tests used in the diagnosis of myocarditis include:

  • Electrocardiogram
  • (
  • ECG )
  • Chest X-ray
  • Ultrasound of the heart (
  • echocardiogram ) -- may show weak heart muscle, an enlarged heart, or fluid surrounding the heart.
  • White blood cell count
  • Red blood cell count
  • Blood cultures for infection
  • Blood tests for antibodies against the heart muscle and the body itself
  • Heart muscle
  • biopsy - rarely performed

    Treatment

    Treatment includes evaluation and treatment of underlying cause. This may require use of antibiotics, reduced level of activity, and low-salt diet. Steroids and other medications may be used to reduce inflammation. Diuretics (medicine to promote removal of body water via the urine) are also given. If the heart muscle is very weak, standard medicines to treat heart failure are also used. Abnormal heart rhythm may require the use of additional medications, a pacemaker or even a defibrillator. If a blood clot is present in the heart chamber, blood thinning medicine is given as well.

    Expectations (prognosis)

    Myocarditis is very variable and the prognosis depends on the cause and the individual patient. Some may recover completely, while others may have permanent heart failure.

    Complications

  • Heart failure
  • Pericarditis
  • Cardiomyopathy
  • Calling your health care provider

  • Call your health care provider if symptoms of myocarditis occur, especially after a recent infection.
  • If you have myocarditis, call your health care provider (or get to the emergency room if symptoms are severe) if you experience increased swelling , chest pain , difficulty breathing , or other new symptoms.

    Prevention

    Prompt treatment of causative disorders may reduce the risk of myocarditis.

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