Myocarditis

What is Myocarditis?

Myocarditis is an inflammation of the heart muscles which decreases the ability of the heart to pump blood. It can be caused by either a viral or bacterial infection. Viral infections are the most common and it can include adenovirus, coxsackievirus, Epstein-Barr virus, HIV, and chickenpox. Myocarditis can also be caused by Lyme disease, alcohol overuse, radiation, and medications such as doxorubicin (Adriamycin).

What are the symptoms of Myocarditis?

  • Chest pain
  • Shortness of breath at rest or during physical activity
  • Swelling of lower extremities due to fluid retention
  • Fatigue 
  • Symptoms of viral infections 

What are the complications of Myocarditis?

Myocarditis can permanently damage your heart causing:

  • Heart failure: due to the muscle damage, the heart can’t pump blood effectively. 
  • Heart attack/stroke: since your heart is damaged and can’t pump blood, the blood accumulates in the heart and causes clots and these can block the arteries that supply blood to the muscles of the heart so they die. 

How is Myocarditis diagnosed?

Different tests can be ordered to aid in the diagnosis of myocarditis. An EKG can be done to check for abnormal rhythms.  A chest x-ray can be done to check for the size of the heart and to check for fluid around the heart which is indicative of heart failure.  An MRI can also be obtained to check for heart inflammation. Blood tests such as troponins and CPK can be obtained to rule out other conditions. 

What are the differential diagnoses of Myocarditis?

  • Congestive heart failure
  • Pneumonia 
  • Angina
  • Myocardial infarction 

How is Myocarditis treated?

Depending on the severity of the condition, it can either be treated at home or as an inpatient. Mild cases should avoid smoking or drinking as well as try to limit strenuous activities. Most of the time Myocarditis gets better on its own without any treatment. In severe myocarditis, since your heart is weak, medications such as ACE inhibitors, ARBs and Beta-blockers are prescribed to reduce the workload of your heart

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