Myocarditis – causes, symptoms, treatment

Proven content

Inflammation of the heart muscle (heart disease) is usually a viral disease. In most patients, myocarditis is caused by enteroviruses, especially Coxsackie type B. Other viruses responsible for the onset of inflammation include Epstein-Barr, mumps, and influenza. The pathogenic agent can also be protozoa of the genus Toxoplasma and bacteria, e.g. coryneforme diphtheria.

What is myocarditis

Myocarditis is a disease of various origins that attacks the heart muscle. The disease can even lead to the destruction of a part of the muscle and, consequently, disruption of its functioning. In some patients, the disease may cause heart failure, and thus the need for hospitalization. The course of the disease and its prognosis are very different and depend on the cause, general health, and less on gender and age. Usually myocarditis is asymptomatic and the patient is unaware that there is something wrong with him. It returns to health by itself. This is nevertheless a dangerous situation, because even in such a case, the heart may become significantly weakened. The etiology of myocarditis should be sought in viral infections. Patients suffering, for example, from the flu, should rest a lot and take care of adequate regeneration in order to avoid complications such as myocarditis.

The causes of myocarditis

Among the causes of myocarditis, there are complications after infections:

1. viral – Coxsackie viruses have the greatest impact, but also hepatitis C virus, adenoviruses, rubella virus, influenza, chickenpox or cytomegalovirus (CMV),
2. bacterial – this group includes infections with staphylococci, pneumococci, bacteria of the genus Haemophilus, Chlamydia, Legionella, Salmonella, Lyme burgorferi,
3. parasitic – the development of the disease can be influenced by human roundworm, tapeworm, Italian worms or protozoa in the form of amoebas or Toxoplasma, exposure to toxic substances,
4. the use of certain medications,

In addition, myocarditis can be caused by some diseases, such as systemic lupus erythematosus. Autoimmune MSM can sometimes present as giant cell myocarditis, especially in young people. In the course of this ailment, the destruction of the heart muscle occurs due to the infiltration of macrophages.

Myocarditis can also attack during sarcoidosis if it affects the heart. However, such a situation occurs relatively rarely. Taking certain medications: anti-tuberculosis, anti-convulsants or anti-inflammatory drugs also leads to MSDs.

In addition, cocaine addicts are also at risk of developing myocarditis because cocaine damages the heart. Certain toxins, such as arsenic, for example, can also contribute to the development of this ailment.

Myocarditis – symptoms

Myocarditis usually has no characteristic symptoms, so it is difficult to make a diagnosis without performing specialist medical examinations. This ailment occurs most often after various types of viral infections, therefore patients who have had them should remember about the possibility of this type of complication. Initially, there are harbingers of the primary infection. Then, cardiac symptoms appear up to several weeks after the heraldic symptoms.

Myocarditis is characterized by heart failure accompanied by:

1. trouble with taking up more physical activity,
2. tiredness,
3. dyspnoea,
4. Dilated cardiomyopathy, i.e. enlargement of both ventricles and simultaneous contractile dysfunction (in severe cases),
5. palpitations,
6. feeling your heart beating fast (especially when exercising)
7. fever,
8. pain in the chest.

Circulatory failure may also appear, which causes an accelerated heartbeat; swelling of the calves and ankles; breathlessness worsening when lying on the back and widening of the veins in the neck.

If you want to check that your heart and cardiovascular system are working properly, do blood tests that determine the basic parameters of the heart. At Medonet Market, you can buy the Heart Control package – blood tests offered by the uP Patient company, whose facilities you can find throughout Poland.

The course and types of myocarditis

Myocarditis can be acute, subacute or chronic.

1. ZMS ostre – the onset of cardiac symptoms is poorly visible, the intensity and their increase is much slower, while the risk of complications is higher. Dilated cardiomyopathy can develop;

2. Chronic MSM – it is characterized by symptoms similar to dilated cardiomyopathy, then the ventricles are enlarged and systolic dysfunction, and eventually progressive failure. The onset of dilated cardiomyopathy has a 50% chance of survival for five years (without proper treatment);

3. ZMS subsharp – it is associated with the presence of a virus in the heart muscle, which is very difficult for the human body to fight. Chronic inflammatory processes gradually destroy the heart.

Prognosis

The best prognosis comes from asymptomatic myocarditis, which is similar to a heart attack. Also, acute patients may recover after the underlying infection has healed. This is possible provided there is no sudden death in the course of the disease. It may happen that the heart conduction impulses are paralyzed and the rhythm is disturbed. Unfortunately, in patients who have had acute or fulminant myocarditis, the heart does not return to its original function. Inflammatory changes are replaced by fibrosis, the properties of which are similar to the tissue of the heart muscle, therefore the heart efficiency is much lower than before MSM.

Important! Severe course of myocarditis occurs in patients who smoke cigarettes habitually. In this group of people, the risk of mortality and heart attack is much higher than in other patients. Drug addicts also run the risk of developing the disease.

Diagnosis of myocarditis

Among the tests performed in the diagnosis of myocarditis, we can mention:

1. blood tests – ESR is significantly elevated in patients with myocarditis. The morphology in turn reveals an increased number of white blood cells (leukocytosis). Elevated levels of eosinophils may also be detected – if the disease was caused by a parasitic infection;
2. echocardiography – thanks to this examination, it is possible to diagnose lightning inflammation, then there is impaired contractility and thickening of the left ventricular wall, with normal diastolic volume;
3. electrocardiography – patients with myocarditis usually have an abnormal ECG picture and have arrhythmias and other conduction disturbances;
4. X-ray examination – it can reveal an enlarged heart with a simultaneous disturbance of its contractility, which indicates an advanced stage of the disease. The test may also show signs of pulmonary congestion and even fluid in the lungs. To distinguish the disease from a recent heart attack, coronography is performed, i.e. X-ray with contrast applied to the arteries in the heart;
5. endomyocardial biopsy – the test involves taking a small piece of heart tissue and then determining possible inflammation or necrosis of cardiomyocytes. A negative biopsy does not mean that the patient does not have inflammation, as the test does not always detect these conditions.
6. Magnetic resonance imaging – a test that allows to reveal inflammation and swelling of the heart, which makes it much easier for a doctor to make a diagnosis.

Myocarditis – treatment

What treatment will be implemented depends on the cause of the disease and the severity with which the heart muscle was affected by the inflammatory process. At the initial stage of the disease, rest and regeneration are important, patients should give up any physical activity for six months. Patients should not take non-steroidal anti-inflammatory drugs as they may worsen myocarditis. If a high temperature appears – it is worth using paracetamol, which has not only antipyretic but also analgesic properties.

Causal treatment of MSS is only initiated when the disease is caused by herpes viruses or Lyme disease.

1. Therapy of mild myocarditis – you only need to cure the symptoms of the infection that led to MSM. Recovery and rest are important.

2. Therapy in patients with complications of myocarditis – hospitalization is necessary in some patients, especially if there is irregular heartbeat, rapid heart rate or chest pain. Insufficient heart contraction may be the basis for the use of preparations that reduce the load on the heart or reduce swelling.

3. Treatment in the event of a fulminant course – the most important thing is the patient’s rest. Sometimes there is a need for intravenous administration of preparations supporting blood pressure. If intravenous medication is unsuccessful, your doctor will order your heart to work with an aortic booster or a pump that directly supports your heart. In extreme cases, a heart transplant is necessary when the heart muscle has been completely destroyed.

Prevention of myocarditis

There are no specific methods to prevent this ailment. Myocarditis can be avoided by restricting contact with people infected with flu-like viruses until they recover. Also, if you are ill, such as with the flu, avoid contact with others to avoid spreading viruses.

It is also important to follow personal hygiene, wash your hands frequently to completely reduce the risk of spreading infection. Preventive measures also include flu and rubella vaccinations.

Can you completely heal yourself?

Myocarditis does not have any complications in most patients. Symptoms usually disappear after a few weeks, and the patient returns to his former state of health. However, some types of infections lead to severe and persistent inflammation and complications. MSM can damage the heart muscle and impair the functioning of the heart, which consequently requires long-term treatment.