Definition
Myocarditis is inflammation of the heart muscle.
See also: Pediatric myocarditis
Figures
Alternative Names
Inflammation - heart muscle
Causes, incidence, and risk factors
Myocarditis is an uncommon disorder that is usually caused by viral, bacterial, or fungal infections that reach the heart.
Viral infections:
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Coxsackie
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Herpes
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Parvovirus
Bacterial infections:
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Mycoplasma
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Streptococcus
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Treponema
Fungal infections:
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Aspergillus
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Candida
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Coccidioides
- Cryptococcus
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Histoplasma
When you have an infection, your immune system produces special cells that release chemicals to fight off disease. If the infection affects your heart, the disease-fighting cells enter the heart. However, the chemicals produced by an immune response can damage the heart muscle. As a result, the heart can become thick, swollen, and weak. This leads to symptoms of heart failure.
Other causes of myocarditis may include:
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Allergic reactions to certain medications or toxins (alcohol, cocaine, certain chemotherapy drugs, heavy metals, and catecholamines)
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Being around certain chemicals
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Symptoms
There may be no symptoms. Symptoms may be similar to the flu. If symptoms occur, they may include:
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Abnormal heartbeat
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Fatigue
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Fever and other signs of infection including headache, muscle aches, sore throat, diarrhea, or rashes
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Joint pain or swelling
- Leg swelling
- Shortness of breath
Other symptoms that may occur with this disease:
Signs and tests
A physical examination may show no abnormalities, or may reveal the following:
Tests used to diagnosis myocarditis include:
Treatment
Treatment is aimed at the cause of the problem, and may involve:
If the heart muscle is very weak, your health care provider will prescribe medicines to treat heart failure. Abnormal heart rhythms may require the use of additional medications, a pacemaker, or an implantable cardioverter-defibrillator. If a blood clot is in the heart chamber, you will also receive blood thinning medicine.
Expectations (prognosis)
How well you do depends on the cause of the problem and your overall health. The outlook varies. Some people may recover completely. Others may have permanent heart failure.
Complications
Calling your health care provider
Call your health care provider if you have symptoms of myocarditis, especially after a recent infection.
Seek immediate medical help if you have severe symptoms or have been diagnosed with myocarditis and have increased:
Prevention
Promptly treating conditions that cause myocarditis may reduce the risk.
References
Liu P, Baughman KL. Myocarditis. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 70.
McKenna W. Diseases of the myocardium and endocardium. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 60.
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