Causes, Diagnosis and Treatment of Myocarditis - Houston Cardiologist

Myocarditis is uncommon and can be caused by a viral infection or a self-directed immune response. Myocarditis is a disease marked by inflammation and damage of the heart muscle. Some autoimmune diseases can affect the heart and cause myocarditis. Rare cases have also been associated with a variety of infections, toxic injuries, adverse drug reactions, and even cancer.

MYOCARDITIS is an inflammation of the myocardium, the middle layer of the heart wall. Myocarditis can affect both the heart’s muscle cells and the heart’s electrical system, leading to reduction in the heart’s pumping function and to irregular heart rhythms.

Causes of Myocarditis:
Viral infection is the most common cause of myocarditis. When you have an infection, your body produces cells to fight infection. These cells also release chemicals. If the disease-fighting cells enter your heart, they can release chemicals that can damage your heart muscle. Your heart may become thick, swollen, and weak. Seeking immediate medical care for infections can help prevent complications. Infections that can cause myocarditis are.
• Parvovirus
• Viral infections
• Coxsackie B viruses
• Epstein-Barr virus (EBV)
• Cytomegalovirus (CMV)
• HIV, Herpes, Hepatitis C

Fungal and parasitic infections can also cause myocarditis. Other causes of myocarditis include certain chemicals or allergic reactions to medications or toxins such as alcohol, drugs, lead, spider bites, wasp stings, or snakebites and chemotherapy and radiation therapy. Having an autoimmune disease such as lupus or rheumatoid arthritis that causes inflammation throughout your body may also lead to myocarditis.

Symptoms of Myocarditis:
The symptoms depend on the cause and severity of the inflammation. Many people with viral myocarditis do not have any heart-related symptoms. The heart inflammation may be suspected by some changes on a heart trace (electrocardiogram, or ECG). Because many viral heart infections create no visible symptoms, the infection can go unnoticed. Symptoms that may occur include:
• An abnormal heartbeat
• Chest pain, muscle aches
• Fever, sore throat, Fatigue
• Joint or leg pain or swelling
• Fainting or shortness of breath

Diagnosis of Myocarditis:
The diagnosis of myocarditis is usually based on diagnosis of exclusion because there are many causes of heart failure. Definite diagnosis of viral myocarditis can only be made with biopsy of the heart muscle, which is a high-risk test. Antibody to the virus may be high in patients with viral myocarditis and can be detected in the blood after a few weeks. Tests used to diagnosis myocarditis include:
• Chest x-ray
• Electrocardiogram (ECG)
• Blood cultures for infection
• Red and white blood cell count
• Heart muscle biopsy (endomyocardial biopsy)
• Ultrasound of the heart (echocardiogram)

Treatment Options:
Patients should rest until symptoms settle. Patients with heart failure and arrhythmia must stay in hospital for treatment of these. Steroids may be used in specific forms of myocarditis. Patients should not take part in any exercise or sports until all symptoms have settled and the ECG and ECHO are back to normal. Over three quarters of people will improve within two weeks without any complications. Around 1 in 10 patients may then develop dilated cardiomyopathy and require lifelong treatment for heart failure.

Prevention of Myocarditis:
Although myocarditis is an unpredictable disease, the following measures may help prevent its onset. Individuals should:
• Limit alcohol consumption to no more than one or two drinks a day, if any.
• Maintain current immunizations against diphtheria, tetanus, measles, rubella, and polio.
• Take extra measures to avoid infections, and obtain appropriate treatment for infections.
• Avoid anything that may cause the abnormal heart to work too hard, including salt and vigorous exercise.

Seek counsel from our leading Heart Doctors in Houston if you suspect you are suffering from any signs and symptoms of Myocarditis for the best treatment options for you.

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