Myocarditis

What is Myocarditis?

• The inflammation of the cardiac muscle (Myocardium) is called Myocarditis.
• When the cardiac muscle is inflamed, the heart cannot pump blood effectively to reach metabolic demands of the body and results in swollen or damaged heart muscle with abnormal heart rhythms.
• Different forms of myocarditis are acute, subacute, or chronic.

What are the symptoms of myocarditis?

In mild cases or early stages of myocarditis, Patient may not experience symptoms or present with mild symptoms like shortness of breath and chest pain.

In most severe or chronic stages, the patient may experience the following symptoms:

• Chest pain
• Shortness of breath
• Abnormal heart rhythms (arrhythmias)
• Fatigue
• Swelling in legs, ankle, or feet

What are the causes of myocarditis?

• Bacterial infections caused by Staphylococcus, Streptococcus, Causative organism of Diphtheria or Tick-borne bacterium
• Viral infections caused by Epstein-Barr virus, Rubella, Hepatitis B & C, Echovirus, HIV, Parvovirus, or Herpes simplex virus
• Parasitic infections caused by Trypanosoma cruzi or Toxoplasma
• Fungal infections caused by Candida, Aspergillus, Histoplasma, or Molds
• Connective tissue disease
• Exposure to radiation therapy
• The allergic reaction towards medicines or toxic drugs like chemotherapeutic drugs, antibiotics like penicillin’s or sulphonamides, anti-seizure drugs, or cocaine
• Autoimmune diseases
• Inflammatory diseases

What are the complications of myocarditis?

• Heart failure: Untreated or undiagnosed myocarditis can damage or swollen the heart muscle that causes the inadequate blood supply to other parts of the body leads to heart failure.
• Arrhythmias
• Brain stroke
• Death

How is myocarditis diagnosed?

• Blood test: To check for infection and inflammation
• Chest X-ray: To check the size and shape of the heart, as well as to identify the presence of fluid in and around the heart that indicates heart failure
• Electrocardiogram: To check the electrical activity of the heart
• Echocardiogram: To check abnormalities in valves, chambers, or blood vessels of the heart
• MRI: To identify the cause of heart muscle damage.
• Endomyocardial biopsy: To check inflammation of cardiac muscle

How is myocarditis treated?

• Angiotensin-converting enzyme (ACE) inhibitors, Angiotensin II receptor blockers (ARB’s) or Beta-blockers to relax the blood vessels and to ease blood flow effectively.
• Diuretics to remove fluid accumulated in legs, ankle or feet.
• Ventricular assist devices: These devices help to pump blood from the lower chambers (ventricles) of the heart to other parts of the body.
• Intra-aortic balloon pump: A thin catheter is inserted near the leg or groin area and directed towards the heart using X-ray imaging. A balloon attached at the end of the catheter placed in the main artery (aorta) that helps in pumping blood effectively.

Extracorporeal membrane oxygenation:

In case of severe heart failure, this device provides oxygen to the body. Blood will be removed from the body and passes into a special membrane where carbon dioxide is removed and adds oxygen to the blood and then return to the body.