Understanding myocarditis: Causes, diagnosis, and treatment

Myocarditis is a medical condition where the heart muscle (myocardium) becomes inflamed. This inflammation can reduce the heart's ability to pump blood effectively, leading to various health issues. Understanding the causes, how it is diagnosed, and the available treatments can help manage and prevent complications from myocarditis. Dr Gosia Wamil, renowned consultant cardiologist, explains more.

What causes myocarditis?

Myocarditis can be caused by several factors, including:

1. Viral infections: The most common cause of myocarditis is a viral infection. Viruses like the common cold, flu, or COVID-19 can trigger inflammation in the heart muscle.
2. Bacterial infections: Less commonly, bacteria such as staphylococcus or streptococcus can cause myocarditis.
3. Parasites and fungi: In rare cases, parasites and fungi can also lead to myocarditis.
4. Autoimmune diseases: Conditions like lupus or rheumatoid arthritis, where the immune system attacks healthy tissue, can cause myocarditis.
5. Medications and drugs: Certain medications, including some cancer drugs, and illegal drugs like cocaine can cause inflammation in the heart.
6. Environmental toxins: Exposure to toxins like carbon monoxide can damage the heart muscle.

Symptoms of myocarditis

The symptoms of myocarditis can vary widely. Some people might not show any symptoms, whereas others may experience:

• chest pain or discomfort
• fatigue and weakness
• shortness of breath, particularly during physical activity or when lying down
• rapid or irregular heartbeats (arrhythmias)
• swelling in legs, ankles, or feet
• lightheadedness or fainting

Diagnosing myocarditis

If myocarditis is suspected, a doctor will perform a thorough evaluation, which may include:

1. Physical exam: The doctor will listen to the heart and lungs, check for signs of fluid retention, and ask about any symptoms and medical history.
2. Blood tests: Blood tests can detect signs of infection, inflammation, or markers indicating heart damage.
3. Electrocardiogram (ECG): An ECG test records the electrical activity of the heart and can reveal abnormal rhythms or heart muscle damage.
4. Echocardiogram: An echocardiogram is an ultrasound of the heart that shows its size, shape, and function, helping detect areas of poor blood flow or damage.
5. Cardiac MRI: A cardiac MRI is an imaging test that provides detailed pictures of the heart, helping identify inflammation or other abnormalities.
6. Chest X-ray: A chest X-ray can show the heart's size and identify any fluid build-up in the lungs.
7. Biopsy: In some cases, a small sample of heart tissue may be taken and examined under a microscope to confirm the diagnosis.

Treatment options

Myocarditis treatment aims to reduce inflammation, manage symptoms, and address the root cause of the condition. Options may vary depending on the severity and could include:

Medications

• Anti-inflammatory drugs: To reduce inflammation and pain.
• Antiviral or antibacterial drugs: If an infection is the cause.
• Heart medications: To manage heart failure symptoms and improve heart function. Examples include beta-blockers or ACE inhibitors.

Lifestyle changes

• Rest: Reducing physical activity to lessen the strain on the heart.
• Diet: Eating a heart-healthy diet low in sodium and saturated fats.
• Avoiding alcohol and smoking: These can exacerbate heart problems.

Medical procedures

• Intravenous (IV) medications: For severe cases where oral medications are not sufficient.
• Mechanical support devices: In extreme cases, devices like a ventricular assist device may be used to help the heart pump blood.

Follow-up care

Regular check-ups with a cardiologist to monitor heart function and adjust treatments as needed.

Myocarditis is a serious condition that necessitates immediate medical attention. Understanding the causes, recognising the symptoms, and knowing the available diagnostic and treatment options can help manage this condition effectively. If you or someone you know is experiencing symptoms of myocarditis, seek medical advice to ensure proper care and prevent complications. With timely intervention, many people with myocarditis can recover and lead healthy lives.

To book an appointment with Dr Gosia Wamil, head on over to her Top Doctors profile today.