Myocarditis

Myocarditis is inflammation of the heart muscle.

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Viral myocarditis

Causes

Myocarditis can be caused by a virus, certain [[drugs, or radiation therapy.

Infectious myocarditis

Myocarditis is most commonly caused by an infection such as influenza (flu) virus, coxsackievirus, parovirus, cytomegalovirus, adenovirus, and others that reaches the heart.

Symptoms

• Chest pain that may resemble a heart attack
• Fatigue or listlessness
• Fever and other signs of infection
• Joint pain or swelling
• Leg swelling
• Pale, cool hands and feet
• Rapid breathing
• Rapid heart rate
• Fainting, often related to irregular heart rhythms
• Low urine output

Work up

Myocarditis can be hard to diagnose because the signs and symptoms often mimic those of other heart and lung diseases, or a bad case of the flu.

Physical exam There may be signs of infection, including fever and rashes.

Imaging studies

• A chest x-ray can show enlargement (swelling) of the heart.
• Electrocardiogram may also be done to help make the diagnosis.
• Heart biopsy is the most accurate way to confirm the diagnosis, but it is not always needed
• Other tests that may be needed include:
• Blood cultures to check for infection
• Blood tests to look for antibodies against viruses or the heart muscle itself
• Blood tests to check liver and kidney function
• Complete blood count
• Special tests to check for the presence of viruses in the blood (viral PCR)

Treatment

• Treatment is aimed at the cause of the problem, and may involve:
• Antibiotics to fight bacterial infection
• Steroids to reduce swelling
• Intravenous immunoglobulin (IVIG)
• Diuretics to remove excess water from the body
• Low-salt diet
• Reduced activity
• Rarely, a heart transplant may be needed.

Myocarditis Resources
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