Myopericarditis

Myopericarditis is a medical condition characterized by the inflammation of both the pericardium (the fibrous sac surrounding the heart) and the myocardium (the heart muscle itself). This condition is a combination of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the pericardium). Myopericarditis can result from various causes, including infections (viral, bacterial, fungal, or parasitic), autoimmune diseases, and exposure to certain drugs or toxins. The clinical presentation of myopericarditis can range from mild symptoms to severe, life-threatening conditions.

Symptoms

Symptoms of myopericarditis may include chest pain that typically worsens with lying down and improves with sitting up, fever, fatigue, shortness of breath, and palpitations. The chest pain associated with myopericarditis is often sharp and may be mistaken for a heart attack. Other symptoms can include swelling of the legs or abdomen due to heart failure.

Causes

The most common cause of myopericarditis is a viral infection. Coxsackievirus, echovirus, and adenovirus are among the viruses frequently implicated. However, bacterial infections (such as those caused by Mycobacterium tuberculosis in areas where tuberculosis is prevalent), fungal infections, and parasitic infections can also lead to myopericarditis. Non-infectious causes include autoimmune diseases like systemic lupus erythematosus (SLE) and reactions to certain medications or toxins.

Diagnosis

Diagnosis of myopericarditis involves a combination of clinical evaluation, electrocardiogram (ECG) findings, blood tests (including markers of cardiac injury such as troponin levels), and imaging studies such as echocardiography. An ECG may show changes indicative of both myocarditis and pericarditis. Echocardiography is useful in assessing the heart's structure and function and can help in identifying any pericardial effusion (fluid accumulation in the pericardial sac).

Treatment

Treatment of myopericarditis focuses on the underlying cause, symptom relief, and prevention of complications. Medications may include anti-inflammatory drugs (such as NSAIDs), colchicine, and corticosteroids, depending on the severity and cause of the inflammation. In cases of bacterial infection, antibiotics are prescribed. Patients with severe cases may require hospitalization for more intensive treatment, including medications to support heart function and procedures to relieve pericardial effusion if present.

Prognosis

The prognosis for individuals with myopericarditis varies depending on the cause and severity of the condition. Many patients recover fully with appropriate treatment, but some may develop chronic conditions such as constrictive pericarditis or dilated cardiomyopathy. Early diagnosis and treatment are crucial in improving outcomes.