Understanding Myocarditis
By Aleena Kuriakose
Highlights:
- Myocarditis is an inflammation of the heart muscle, weakening the heart and making it difficult for the muscle to pump.
- Myocarditis can be caused by viral infections and autoimmune disorders
- Myocarditis is diagnosed through common tests such as an electrocardiogram, a chest-x-ray, an echocardiogram, an MRI scan, or even a heart biopsy.
Introduction
The heart is a vital fist-sized organ that pumps 7,000 liters of blood through the body each day. It is an extraordinary organ that has incredible endurance and strength, beating over 2.5 million times in one’s lifetime. It serves as the main component of the cardiovascular system and supplies oxygen to cells. With no doubt, it is essential to have a healthy heart and live a lifestyle that includes a good diet and exercise. Yet, it is as equally as important to recognize an unhealthy heart. Myocarditis is just one of many cardiovascular diseases that can impair a person’s heart function and lifestyle. However, with proper treatment, care, and understanding, heart function can be improved.
Myocarditis: Causes and Effects
Myocarditis is an inflammation of the heart muscle, weakening the heart and making it difficult for the muscle to pump. It differs from other types of inflammation of the heart, such as endocarditis and pericarditis because myocarditis specifically affects the heart muscle, whereas the others affect the inner lining of the heart and the sac around the heart, respectively.
Often, the cause for myocarditis is unknown, but it is usually caused by a viral infection, which includes:
- Flu
- Herpes virus six
- Adenovirus
- Coxsackie virus
- Parvovirus B19
- SARS-CoV-2 (COVID-19)
Myocarditis can also be caused by autoimmune disorders such as lupus and sarcoidosis. As a result, there are several classifications of myocarditis and common ones include acute myocarditis, chronic myocarditis and lymphocytic myocarditis:
- Acute Myocarditis: Acute Myocarditis is usually caused by viral infection and describes recent or fast onset of inflammation. It can develop suddenly.
- Chronic Myocarditis: Chronic Myocarditis can be caused by autoimmune disorders and describes when it takes longer than usual to treat the disease or if symptoms persist even after experiencing the condition.
- Lymphocytic Myocarditis: Lymphocytic Myocarditis is a rare form of myocarditis that can result in hospitalization for acute care. This form of myocarditis happens when lymphocytes, or white blood cells, enter and cause inflammation of the heart muscle; this can happen after a virus.
Symptoms, Diagnosis, & Treatment
Symptoms of myocarditis include:
- Shortness of breath, especially after exercise or when lying down
- Fatigue
- Heart palpitations
- Chest pain or pressure
- Lightheadedness
- Swelling in the hands, legs, ankles and feet
- A sudden loss of consciousness
Myocarditis is diagnosed through common tests such as an electrocardiogram, a chest-x-ray, an echocardiogram, an MRI scan, or even a heart biopsy. An electrocardiogram detects electrical activity of the heart through electrodes taped to the skin. The activity is recorded as waves that show the electrical forces in different parts of the heart. A chest x-ray outlines the heart, lungs, and other structures in the chest that would allow a physician to understand the size and shape of the patient’s heart. From an echocardiogram, sound waves are used to interpret blood flow or the image of the heart. Sound waves are sent into the body from a transducer, a small plastic device that reflects back from internal structure and produces images of the heart and its structures. An MRI scan also produces images of the heart but by using a magnetic field and radio waves.
Treatments for myocarditis include medications such as:
- Corticosteroids: Corticosteroids may improve rare types of viral myocarditis that acts by suppressing the immune system.
- Heart medications: Myocarditis may cause heart failure or arrhythmias. In the case of abnormal heart rhythms or severe heart failure, heart medications may be prescribed to reduce the likelihood of blood clots forming in the heart.
- If your heart is weak, blood pressure medications may be prescribed to alleviate the strain on the heart. These medications can include diuretics, beta blockers, angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs).
- Medications to treat chronic conditions: if myocarditis is caused by a chronic illness, such as lupus, treatment is directed at the underlying disease.
References:
https://www.myocarditisfoundation.org/about-myocarditis/
https://www.hopkinsmedicine.org/health/conditions-and-diseases/myocarditis
https://my.clevelandclinic.org/health/diseases/22129-myocarditis
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.html
https://www.cdc.gov/mmwr/volumes/70/wr/mm7035e5.htm
https://www.mayoclinic.org/diseases-conditions/myocarditis/diagnosis-treatment/drc-20352544
