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The heart muscle is known as myocardium and infection of the myocardium is medically termed as myocarditis. The infection is usually caused by microbes, which spreads to the heart. Let’s study myocarditis in depth...

What causes myocarditis

Several reasons are assumed to cause infection to the heart muscle. External microbes like virus, bacteria, parasites and fungi can potentially infect the myocardium. Amongst these, viral infections by coxsackievirus B, parovovirus B 19, adenovirus, Epstein-Barr virus, etc. are more predominant.

Exposure to illicit drugs, toxicity from alcohol, heavy metals, insect and snake bites, chemotherapy, radiation therapy, or allergic reaction to certain medicines like penicillin and sulfonamide can lead to myocarditis.

People suffering from connective tissue complications, inflammatory diseases (e.g. Wegener's granulomatosis) and autoimmune disorders (lupus, rheumatoid arthritis) can also have myocarditis.

Symptoms of myocarditis

The infection can range from mild to severe. In most cases, there are no noticeable symptoms when the infection is mild. However in potentially serious cases, the individual will be experiencing

  • Chest pain
  • Edema in legs and feet
  • Shortness of breath
  • Abnormal heartbeat
  • Lightheadedness
  • Decreased urine output

The general symptoms of microbial infection will also be observed which include body ache, fever, cold, diarrhea, etc.

What are the complications of myocarditis?

The anti-inflammatory cells of the body release chemicals to fight microbial infection. If those chemicals or cells enter the heart, they can cause major damage to the heart muscle i.e. the heart swells, becomes thick and weak.

If the infection is severe, then one can have heart failure, heart attack and sudden cardiac arrest, which could be fatal

So when to see a doctor?

Obviously you need to see a doctor on having viral infection. Nonetheless, you cannot afford to delay in medical check-up when experiencing chest pain, irregular heartbeat and other symptoms explained above.

Diagnosis of myocarditis

Your doctor will perform a physical exam and check the symptoms (chest pain, swelling, rapid heartbeat) of myocarditis. However, the underlying cause can be determined only through diagnostic tests which are:

  • CBC tests, blood test for infections, antibodies and heart muscle enzymes
  • Chest x ray, ultrasound of the heart or echocardiogram
  • Cardiac magnetic resonance imaging
  • Electrocardiogram to detect abnormal heartbeat
  • Endomyocardial biopsy

Treatment of myocarditis

Myocaritis is completely curable. Treatment involves treating the underlying cause and simultaneously improving the condition of the heart.

Anti-inflammatory drugs and antibiotics help to combat the infection. Subsequently irregular heartbeat, heart failure, swelling and other types of complications in the heart can be typically managed by ACE inhibitors, beta blockers, diuretics, and angiotensin receptor blockers.

If major damaged has been caused, like that of blood clots or weakened heart or under emergency situations, doctors might consider placing external devices like artificial heart valve, aortic pump, extracorporeal membrane oxygenation, and implantable cardioverter-defibrillator to deal with the emergency. You will be hospitalized and a follow up treatment post operation will also be required.

Lifestyle changes for myocarditis

Along with treatment, your doctor will suggest several lifestyle changes that will help you to recover quickly. They include:

  • A low salt diet
  • You may be asked to consume fluids in moderation. Check with your doctor what kinds of fluids would suit your health
  • Rest. Reduced physical activity until you are completely cured
  • Avoid smoking, drinking or any other activities that would make you susceptible to infections and are detrimental for your heart.

With proper treatment and care recovery is completely possible.

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Written by: Saptakee sengupta
Date last updated: January 30, 2015