7 Unique Ways of Diagnosing Myocarditis

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Diagnosing myocarditis

Myocarditis is a condition in which the heart muscle becomes inflamed. This condition develops due to a viral infection, immune system disorders, or other conditions. Myocarditis may lead to heart failure and other serious complications. Myocarditis treatment typically involves managing the underlying condition and supporting the heart with medications.

Myocarditis most often occurs due to a viral infection, such as influenza or Coxsackievirus. However, myocarditis may also happen due to bacteria, fungi, or parasites. In some cases, myocarditis may be due to an autoimmune disorder, where the body's immune system attacks healthy tissues. Medications or toxins can also cause myocarditis.

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Myocarditis signs range from mild to severe. In some cases, myocarditis may cause no symptoms at all. When myocarditis does cause symptoms, they may include fatigue, shortness of breath, chest pain, and irregular heartbeat. Myocarditis can also lead to heart failure and other complications.

Causes and Complications of Myocarditis

Viral infections are the most common cause of myocarditis. Viruses that can cause myocarditis to include:

-Coxsackievirus

-Influenza virus

-Adenovirus

-Herpes simplex virus

Bacterial infections can also cause myocarditis, though this is less common. Bacteria that can cause myocarditis to include:

-Mycoplasma pneumonia

-Chlamydia pneumoniae

In some cases, myocarditis may be due to an autoimmune disorder, where the body's immune system attacks healthy tissues. Certain medications or toxins can also cause myocarditis.

Autoimmune disorders: Autoimmune disorders can cause the body's immune system to attack healthy tissues. This condition can lead to myocarditis. Examples of autoimmune disorders that can cause myocarditis to include:

-Lupus

-Rheumatoid arthritis

-Sarcoidosis

Medications: In some cases, myocarditis may be a side effect of certain medications. Medications linked to myocarditis include:

-Tumor necrosis factor (TNF) inhibitors

-Hepatitis C virus (HCV) protease inhibitors

Toxins. Myocarditis may also develop by exposure to certain toxins, such as:

-Cobalt

- Mercury

- Alcohol

Radiation therapy:  In some cases, myocarditis may develop due to radiation therapy, most common in people who have received radiation therapy to the chest.

Myocarditis can lead to issues such as heart failure and other serious complications. Myocarditis treatment typically involves managing the underlying condition and supporting the heart with medications.

  • Heart failure: Myocarditis can lead to heart failure, which is a condition in which the heart cannot pump enough blood to meet the body's needs. Heart failure can be mild, moderate, or severe. In some cases, heart failure can be life-threatening.
  • Arrhythmias: Myocarditis can also cause arrhythmias, which are abnormal heart rhythms. Arrhythmias can range from mild to life-threatening.
  • Cardiogenic Shock: In some cases, myocarditis can lead to cardiogenic shock, a medical emergency. Cardiogenic shock occurs when the heart cannot pump enough blood to meet the body's needs. This condition can lead to organ failure and death.

Myocarditis Symptoms and Diagnosis

Myocarditis symptoms can range from mild to severe. In some cases, myocarditis may cause no symptoms at all. Myocarditis symptoms may be similar to those of a heart attack. When myocarditis does cause symptoms, they may include:

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-Fatigue

-Shortness of breath

-Chest pain

-Irregular heartbeat

If a person experiences any of these symptoms, it is essential to see a doctor as soon as possible. Myocarditis can lead to heart failure and other serious complications.

Diagnosing myocarditis typically begins with tests, including a physical exam, blood tests, and imaging tests.

A doctor will likely start by doing a physical exam and taking the patient's medical history. They may also order blood tests and imaging tests to confirm the diagnosis.

Physical exam: During a physical exam, the doctor will check for signs of myocarditis, such as heart murmur or irregular heartbeat. They will also perform a physical exam.

Imaging tests: Imaging tests can help the doctor with diagnosing myocarditis. Imaging tests may include an echocardiogram, MRI, or CT scan.

EKG: An EKG is a test that measures the heart's electrical activity. An EKG can often show signs of myocarditis.

Chest X-Ray: A chest x-ray can often show signs of myocarditis.

Echocardiogram: An echocardiogram is a test that uses sound waves to create images of the heart. An echocardiogram may show signs of myocarditis, such as fluid around the heart.

Cardiac catheterization and heart muscle biopsy: Cardiac catheterization is a test that uses a thin, flexible tube to take pictures of the heart. A heart muscle biopsy is a procedure in which a small sample of heart tissue is removed and examined for signs of myocarditis. Cardiac catheterization and heart muscle biopsy often happen at the same time.

Blood tests: Blood tests can help a doctor check for viral infections, autoimmune disorders, and other conditions that can cause myocarditis.

Myocarditis Treatment

Myocarditis treatment typically involves managing the underlying condition and supporting the heart with medications. Medications used to treat myocarditis include:

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  • Corticosteroids: Corticosteroids are anti-inflammatory medications that can help reduce inflammation in the heart.
  • Immunosuppressants: Immunosuppressants are medications that suppress the immune system. They can be used to treat autoimmune forms of myocarditis.
  • ACE inhibitors: ACE inhibitors are medications that can help improve blood flow and reduce congestion. They are often used to treat heart failure.
  • Beta-blockers: Beta-blockers are medications that can help to slow the heart rate and reduce blood pressure. They are frequently used to treat arrhythmias.
  • Antiarrhythmics: Antiarrhythmics are medications that can help regulate the heart's rhythm. They are typically used to treat arrhythmias.
  • Cardiac rehabilitation: Cardiac rehabilitation is a program of exercise and education designed to help people with heart conditions recover from an event such as a heart attack or surgery.
  • Surgery: In some cases, surgery may be necessary to repair damage to the heart. The type of surgery will depend on the damage to the heart. Surgery is typically only considered for people with severe myocarditis. Myocarditis surgery may include:

-Coronary artery bypass grafting (CABG): CABG is a type of surgery used to bypass blocked or damaged arteries.

-Heart transplant: A heart transplant may be an option for people with severe myocarditis who do not respond to other treatments. Heart transplants are typically only considered for people with end-stage heart failure. Heart transplants involve surgically removing the damaged heart and replacing it with a healthy donor heart. Heart transplants can be life-saving, but they also come with risks. The risks of heart transplant surgery include infection, rejection of the donor's heart, and bleeding. Heart transplants require lifelong immunosuppressant therapy to prevent rejection of the donor's heart. The decision to have a heart transplant is a complex one. It is essential to discuss all options with a doctor to ensure that the patient makes the best decision for their situation. Heart transplants are a last resort option and are typically only considered for people with severe myocarditis who have not responded to other treatments. If a person is considering a heart transplant, it is crucial to be as healthy as possible before surgery. Staying healthy means quitting smoking, maintaining a healthy weight, and controlling any other medical conditions that a person may have. Heart transplant surgery is a significant operation, and it is essential to be as prepared as possible before having the surgery.

After a heart transplant, a patient will need to take immunosuppressant medications to prevent rejection of the donor's heart. They will also need to follow a strict schedule of checkups and testing.

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  • IV Medications: IV Medications are medications given through an IV. IV Medications can help treat the symptoms of myocarditis by helping the heart's ability to pump.
  • Ventricular Assist Devices: Ventricular assist devices are mechanical devices used to help the heart pump. Ventricular assist devices may be used as a short-term or long-term treatment for myocarditis. Ventricular assist devices can also be used as a bridge to transplant for people with myocarditis who are waiting for a heart transplant.
  • Intra-aortic Balloon Pump: Intra-aortic balloon pumps are mechanical devices used to help the heart pump. Intra-aortic balloon pumps may be utilized as a short-term treatment for myocarditis. Intra-aortic balloon pumps work by taking over the pumping action of the heart. Intra-aortic balloon pumps get placed in the aorta. The aorta is the large artery that carries blood from the heart to the rest of the body.
  • Cardioversion: Cardioversion is a procedure used to reset the heart's rhythm. 
  • Extracorporeal Membrane Oxygenation: Extracorporeal membrane oxygenation (ECMO) is a procedure used to support the heart and lungs. ECMO works by taking over the function of the heart and lungs. ECMO can be used as a short-term treatment for myocarditis. ECMO is typically only used for people with severe myocarditis who are not responding to other treatments.

Recovery from Myocarditis and Prevention

The recovery process from myocarditis can vary depending on the severity of the condition. People with mild myocarditis typically recover within a few weeks with no lasting effects. People with more severe myocarditis may require hospitalization and may have long-term effects such as heart failure.

There is no sure way to prevent myocarditis, but there are some things a person can do to lower their risk:

-Get vaccinated against viral infections: Viral infections are a common cause of myocarditis. Getting vaccinated can help to prevent these infections.

-Avoid exposure to toxins: Exposure to toxins such as alcohol or drugs can increase the risk of myocarditis. Avoiding these substances can help to lower this risk.

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-Wear protective clothing: Wearing protective clothing when exposed to chemicals or other toxins can help reduce the risk of exposure.

-Manage underlying conditions: Managing underlying conditions such as diabetes or hypertension can help lower the risk of myocarditis.

-Avoid risky behaviors: Avoiding risky behaviors such as smoking and excessive alcohol consumption can help lower the risk of myocarditis.

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