Myocarditis: symptoms and treatment

The heart is one of the most important organs in the human body. The overall health of our entire body depends on the condition of the heart. The human heart is made up of a special type of muscle tissue.

 Myocarditis is an inflammation of the heart muscle (myocardium). This development of the inflammatory process can reduce the heart's ability to pump blood through the body and cause the development of irregular heartbeats (arrhythmias) and other complications.
Acute myocarditis is defined as a relatively recent or rapid onset of inflammation of the heart muscles  and is usually caused by a viral infection. With chronic myocarditis, the disease lasts longer and symptoms may disappear and reappear again.
Myocarditis can occur at any age, both in adults and children.

Symptoms of the disease

One of the biggest problems for the diagnosis and treatment of myocarditis is the lack of specific symptoms. In many cases, the person does not experience symptoms of myocarditis at all. If complaints are present, they are caused by the viral infection itself or indicate other heart problems, such as heart failure.

Possible symptoms of acute myocarditis include:

• shortness of breath
• feeling of pressure or pain behind the chest
• heartbeat
• heart rhythm disorders
• pallor due to lack of oxygen in the blood
• enlargement of the spleen and liver
• swelling of the lower extremities

Causes of myocarditis

Myocarditis is a rather rare disease. The development of inflammation in the heart muscle is not due to the pathogen itself entering the heart, but to the response of the human immune system to this process.

Possible causes of inflammation of the heart muscle include:

• Viruses are the most common cause of myocarditis. Such viruses include: adenovirus, COVID-19, hepatitis B and C, parvovirus, herpes simplex virus, echoviruses, Epstein-Barr virus, also common in people with HIV.
• Bacteria that can cause myocarditis include staphylococcus, streptococcus, diphtheria and Lyme disease.
• Parasites, including parasites such as Trypanosoma cruzi and Toxoplasma.
• Very rarely, myocarditis can be caused by fungi (in people with weakened immune systems).
• Myocarditis also sometimes occurs with the use of drugs or illicit drugs (drugs used to treat cancer; antibiotics such as penicillin and sulfonamides; some anticonvulsants; cocaine).
• Chemicals or radiation. Exposure to certain chemicals, such as carbon monoxide, and radiation can sometimes cause myocarditis.
• Other diseases. These include diseases such as systemic lupus erythematosus, Wegener's granulomatosis, giant cell arteritis and Takayasu's arteritis.

Diagnosis of myocarditis

Myocarditis can be quite difficult to diagnose due to non-specific symptoms and signs. During the admission to the clinic, the doctor conducts a detailed examination and collects all complaints and medical history.
The following tests and instrumental methods may be required for diagnosis:
• Blood test (detection of inflammation, determination of LDH, CPK, etc.)
• Chest x-ray
• Electrocardiogram (ECG)
• Echocardiogram (ultrasound of the heart)
• In some cases, an MRI of the heart may be indicated

Treatment

Treatment of myocarditis is aimed at relieving the symptoms (heart failure, arrhythmias, etc.) and the causes of inflammation of the heart muscle, if it can be detected. There is no special treatment for myocarditis. Your doctor individually selects the therapy that will be suitable in your case.