Understanding Myocarditis: Causes | Diagnosis | Symptoms | Treatment

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by Jordan Nacalaban Jordan Nacalaban, BSN, RN

Specializes in MS, Tele, Cardiac, Post-Trauma Surgical, Ortho. Has 16 years experience.

Learn about myocarditis and how to recognize it—this article on understanding its causes, diagnosis, symptoms, risks, and treatment options available. It also includes actionable steps to reduce acquiring myocarditis.

Myocarditis: A Serious Heart Matter

Understanding Myocarditis: Causes | Diagnosis | Symptoms | Treatment

Myocarditis is an inflammatory medical condition that affects a person’s heart muscle. When your heart muscles become inflamed, it affects the ability of the heart to function well.1

When inflammation of the heart happens, the muscle becomes enlarged, which may contribute to heart failure, heart dysfunction, or even sudden death. 

Myocarditis may also affect your heart’s electrical function leading to a severe problem called arrhythmia (a heart condition in which your heart beats with an abnormal or irregular rhythm).2

It is a rare form of heart disease that affects everyone, even young individuals and children (pediatric myocarditis).

How does one get myocarditis?

When an infection occurs, which is the common cause of myocarditis, it may be caused by any of the following

Viruses:

Those from Covid-19, Influenza virus, Parvovirus B19, Human Herpesvirus 6, Enterovirus, etc. 6

A viral infection is the most common cause of myocarditis—one of the main reasons individuals need to be careful around known illnesses. 

Bacteria: 

Myocarditis can also be caused by strep, staph, and tick-borne bacteria, causing Lyme disease. In addition, other causes of myocarditis are Corynebacterium diphtheriae (Diphtheria) and Mycobacterium Tuberculosis (TB). 3

Fungus:

Those include yeast infections from candida or molds. You can also develop myocarditis from Histoplasma coming from bird droppings. 

It is widely seen in persons with immunocompromised systems, including persons with HIV.

Parasites: 

Some parasites that cause myocarditis include Trichinella spiralis - Tapeworms: Echinococcus from dogs, Taenia solium from pork. 

One of the parasites causing myocarditis is Trypanosoma cruzi, which comes from insects and is common in Latin America.3

Other Causes of Myocarditis: 

Myocarditis is primarily the result of an infection in your body, but you can also get it from other causes.

Autoimmune disease:

Lupus, Rheumatoid Arthritis, Irritable Bowel Syndrome (IBS)

Systemic Disease: 

Sarcoidosis, Celiac disease

Toxins or Drug reactions: 

cocaine, phenothiazine, some chemotherapeutic drugs, and other drugs

Environmental: 

carbon monoxide, radiation, lead, arsenic3

Common Symptoms

Some individuals don’t have any symptoms in the early stages of myocarditis.

Some will have mild symptoms.

Each case of myocarditis greatly varies. Therefore, it’s best to get ahold of your physician and have them examine you. Below are symptoms of myocarditis, which are not limited.

Symptoms you may experience with myocarditis:

  • Chest Pain
  • Shortness of Breath (rest or activity)
  • Fatigue
  • Abnormal or Rapid Heart Rhythm
  • Fever
  • Headache
  • Muscle Aches
  • Sore Throat
  • Diarrhea
  • Joint Pain
  • Swelling of the legs, ankles, or feet

How do you know if you have myocarditis?

Your physician may examine you and order non-invasive testing or advanced diagnostic tests.

Those tests may include the following:

  • Electrocardiography (ECG): assess the electrical signals of your heart
  • Echocardiogram: an ultrasound of your heart and its structures
  • Chest X-ray: imaging can show enlargement of the heart
  • Blood Test: heart markers, blood cultures (viral, bacterial tests), complete blood count, etc.5
  • Cardiac MRI: indicated for people with symptoms and suspected myocarditis. It can be helpful with treatment management planning. 3
  • Heart Biopsy (Endomyocardial Biopsy - EMB): indicated for new-onset unknown heart failure symptoms less than two weeks of duration, unresponsive to treatment within 1-2 weeks. After the physicians had excluded all other underlying causes of myocarditis, this test is suggested.3
  • Cardiac Catheterization: an examination is done to visualize the heart and the extent of damage and may be used to repair the heart without surgery.

Myocarditis Treatment

There is no cure for myocarditis. However, some people with myocarditis get better on their own or with any medical treatment and may recover fully.

Your physician will recommend treatment for myocarditis based on your case, the cause of your myocarditis, and the symptoms you are experiencing.

Rest: 

It can’t be stressed enough when rest is recommended to treat myocarditis. Resting will help you recover from the condition, which helps your heart heal by reducing stress on its valves to prevent further damage.

Medication:

These medications are prescribed based on individual cases and causes of myocarditis. In addition, your physician considers the severity and type of myocarditis you have. 

  • Heart Failure medications - to help reduce your heart’s workload 3
  • Anti-inflammatory drugs - you may receive medications to decrease inflammation in your heart
  • Anti-viral treatment - if you have myocarditis caused by a virus, you may be given these medications to combat viral infections
  • Immunosuppressive therapy (corticosteroids) - supports your immune system by lowering inflammation. Medications that suppress your immune system have treatment benefits for people who have acute lymphocytic myocarditis and giant cell myocarditis.3
  • Antiarrhythmic medications - intended to control the rhythm of your heart
  • Immunoglobulin IV therapy (IVIG) - enhances immune system support; IVIG contains anti-viral and anti-inflammatory effects on myocarditis.4

Addressing your underlying conditions 

Your physician will also look at any present medical conditions when planning treatment.

Procedures

Surgery

  • Heart transplant

Lifestyle changes

Your physician may recommend limiting physical activity such as contact sports for a specified time (3 to 6 months). The focus is to help your heart heal. Ask questions concerning exercise, activity restrictions, and when to resume them.6

To promote heart health, your physician may recommend:

  • Quitting smoking.
  • Limiting your sodium intake.
  • Monitoring your fluids.
  • Avoiding alcohol and other health modifiers. 

Complications of Myocarditis

When myocarditis is left untreated, complications may happen even when under treatment.

Listed below are complications of myocarditis:

What to do to reduce the chance of getting myocarditis?

Although there is no known, full-proof preventive method against myocarditis, these simple tips may help you not get myocarditis.

  • Avoid people who are sick with viral or flu-like symptoms. 
  • Follow a healthy lifestyle for overall health.
  • Reduce your risk of getting other illnesses. If you feel sick, stay at home to prevent a possible spread of infection.
  • Continue good hygiene - wash hands, use sanitizers, clean surfaces
  • Avoid risky behavior: illegal drugs, practice safe sex, cook food to the appropriate temperature. 
  • Be prepared when going hiking. Prevent ticks exposure by wearing long sleeves and pants during your hikes.
  • Get vaccinated to prevent illness and diseases. 
  • Prioritize your immune system.
  • Obtain accurate and current information regarding myocarditis from reputable sources.

Summary:

Myocarditis affects your heart’s ability to function well. Your physician may order tests to determine the severity of your condition and map out treatment. 

It can occur to people who aren’t aware of the symptoms they’re experiencing. The goal is to get an early diagnosis of myocarditis. When myocarditis is suspected, it’s important to see your physician without delay.

One may acquire a mild case of myocarditis, and you recover. Another may be severe, leading to intensive care and life-threatening situations. It’s important to remember that it may come back even though myocarditis has resolved.

Health outcomes may depend on your body’s response to treatment and timely diagnostics to set a clinical route for treating myocarditis. 

Your physician prioritizes the timely diagnosis of myocarditis and a treatment care plan that may help you recover. 

Most persons with myocarditis can recover from uncomplicated medical interventions to multi-approach treatment. Unfortunately, however, some people’s conditions deteriorate quickly, even dying from myocarditis. 

If you suspect you are experiencing symptoms that point to myocarditis, you should talk to your physician immediately. 

When you’re recovering from myocarditis, it’s crucial to seek follow-up care with your physician.


References

1. Johns Hopkins Medicine | Myocarditis (n.d.) 

2. MedlinePlus | Arrhythmia | Irregular Heartbeat (July 09, 2021) 

3. Blauwet, Lori A, and Leslie T Cooper. “Myocarditis.” Progress in cardiovascular diseases (2010) doi:10.1016/j.pcad.2009.11.006

4. Huang, Xin et al. “Intravenous Immunoglobulin Therapy for Acute Myocarditis in Children and Adults.” International heart journal vol. 60,2 (2019): 359-365. doi:10.1536/ihj.18-299

5. Kang M, An J. Viral Myocarditis. [Updated 2022 Jan 5]. In: StatPearls [Internet]. Treasure Island (FL). StatPearls Publishing 

6. National Heart Lung and Blood Institute | Heart Inflammation (n.d.) 

Jordan Nacalaban BSN RN MED-SURG-BC is a freelance health content writer specializing in medical-surgical, trauma-surgical, pain management, and chronic health conditions. Her significant nursing expertise and skills pave the way for developing health material that is engaging, factual, and well-researched.

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2 Comment(s)

amoLucia

amoLucia

Specializes in retired LTC. 7,735 Posts

Another informative & easy to read article. We readers have been lucky to recently have had several similar articles that add to our knowledge bases. 

TY for this contribution.

Jordan Nacalaban, BSN, RN

Specializes in MS, Tele, Cardiac, Post-Trauma Surgical, Ortho. Has 16 years experience. 4 Articles; 21 Posts

21 minutes ago, amoLucia said:

Another informative & easy to read article. We readers have been lucky to recently have had several similar articles that add to our knowledge bases. 

TY for this contribution.

Thank you!