A health condition that causes inflammation of the heart muscle (myocardium) is called myocarditis. It often weakens the heart, which negatively affects its function. While it may occur due to a viral infection, some inflammatory disorders may also cause it.
However, myocarditis is different from other conditions that cause inflammation because each disorder causes inflammation in different parts of the heart. For instance, pericarditis negatively affects the sac around the heart muscle, but endocarditis is an infection or inflammation of the heart valves. Furthermore, there are some types of myocarditis that occur very rarely. Examples include Giant cell myocarditis, Eosinophilic myocarditis, Fulminant myocarditis, and Lymphocytic myocarditis.
In general, this condition occurs commonly, and it affects about 1.5 million people worldwide each year. Approximately 10 to 20 out of every 100,000 people develop myocarditis.
What Are The Symptoms of Myocarditis?
While sometimes, people do not have any symptoms, in more advanced stages, they may experience the following ones. Check some examples below:
- Dyspnea (shortness of breath)
- Abdominal (belly) pain
- Lightheadedness
- Tiredness
- Fever
- Chest pain (angina)
- Fainting
- Arrhythmia (irregular heart rhythm)
- Heart palpitations
- Weakness
- Appetite changes
- Swollen legs or feet
- Inability to perform physical exercise
Do not hesitate to visit a doctor if any of the previous symptoms occur. Without treatment, myocarditis may cause serious complications.
Causes and Risk Factors
In most cases, doctors cannot determine the exact cause. Frequently, it occurs in people with one of the following viral infections. These include:
- SARS-CoV-2 (COVID-19)
- Parvovirus B19
- Coxsackie virus
- Adenovirus
- Herpes virus six
- Flu
However, it may also occur due to other causes. For example:
- Rheumatic fever
- Chagas disease
- Fungi
- Bacteria
- Autoimmune disorders (including rheumatoid arthritis and systemic lupus erythematosus)
- Prolonged exposure to radiation or heavy metals
Some people may also develop myocarditis as an adverse reaction to the following medications. Examples include:
- Diuretics (also known as water pills)
- Anti-seizure medicines
- Antidepressants
- Heart medicines
- Medicines for weight loss
- Benzodiazepines
- Other medicines used to treat psychiatric problems
- Antibiotics
While anyone can develop this condition, the following factors may increase your risk even more. Check some of them below:
- Misuse of alcoholic drinks
- Sex – Males are slightly more prone to myocarditis than females.
- Age – Usually, it occurs in young adults, but it may affect people of all ages.
- Certain inherited genes
- Dialysis
- Radiation
- Implanted heart devices
- Central venous line
- Chest injuries
- Eating disorders
- Cancer treatments (such as chemotherapy)
- Skin injuries or infections
- HIV/AIDS
- Diabetes
- End-stage kidney disease
What Are The Long-term Effects of Myocarditis?
People who develop this condition and do not get treatment may experience some long-term problems. Check some complications below:
- Lung problems
- Heart failure
- Cardiomyopathy
- Cardiogenic shock
- Sudden cardiac death
- Arrhythmia (irregular heart rhythm)
- Stroke
- Heart attack (also known as myocardial infarction)
The previous list does not contain all possible myocarditis complications. However, doctors may recommend some tips that could help reduce the risk or even prevent them.
Is There a Way to Prevent Myocarditis?
In general, it is very hard to prevent this condition. One of the best ways to reduce the risk is to prevent viral infections by washing your hands regularly with soap and warm water and avoiding sick people. You should also stay up to date on the flu vaccine. Moreover, there are some risk factors that can be managed. For example, limit or avoid alcoholic drinks, stop smoking, perform regular physical activity, and others. Discuss it with your physician for more details.
Diagnosis
Doctors often start the diagnosis of this condition with a physical examination and questions about your medical history and symptoms. In any case, to exclude or confirm myocarditis, they will perform the following tests and procedures. These include:
- MRI (magnetic resonance imaging) scans
- PET (positron emission tomography) scans
- Heart biopsy – During this procedure, physicians will take a small sample of the affected heart tissue for testing.
- Chest X-ray
- Cardiac catheterization
- Electrocardiogram (EKG or ECG) – This is a quick and painless test used to measure the electrical activity of the heart. It usually helps identify arrhythmia.
- Echocardiogram
- Blood tests
Treatment
Usually, mild forms of myocarditis go away on their own without treatment. If you develop a moderate to severe myocarditis, doctors may recommend one or a combination of the following treatments. Examples include:
- Heart failure medications
- Corticosteroids – This group of medicines is used to reduce inflammation and ease the symptoms caused by myocarditis.
- IV (intravenous) immunoglobulin
If you develop heart failure or arrhythmia, physicians often recommend surgery to implant one of the following devices. For example, LVAD (left ventricular assist device), pacemaker, or Donor heart.
Frequently Asked Questions
What does myocarditis feel like?
Commonly, people who develop this heart condition feel very tired and experience angina (heart-related chest pain), dyspnea, or palpitations (racing heart). While these symptoms may appear gradually over time, in some people they occur suddenly. More advanced stages of myocarditis can cause heart failure or severe arrhythmia, which is fatal without immediate treatment.
How do I take care of myself with myocarditis?
It is important to remember that myocarditis may return years later. That’s why doctors usually recommend the following tips. For example:
- Stop smoking – If you have problems with smoking cessation, discuss it with your physician.
- Avoid alcoholic beverages
- Limit salt in your diet
- Do not perform physical exercise without your doctor’s approval
- Administer medicines exactly as recommended by your physician
- Keep your follow-up appointments with your doctor
What is the prognosis with myocarditis?
Typically, the prognosis varies among people with myocarditis because it depends on the severity of the symptoms and how inflamed your heart is. While some people can live for many years after treatment, others may need to administer medicines. Moreover, people who have already had myocarditis still have a chance of developing it again. Additionally, some people may develop life-threatening complications, such as dilated cardiomyopathy, heart failure, and others. This heart condition is also linked to nearly 20% of sudden deaths in young people. In any case, 50% to 80% of people with viral myocarditis survive 5 years or more after diagnosis.
Can myocarditis go away on its own?
Yes, mild cases of myocarditis may resolve without specific treatment. The body can sometimes recover from the inflammation naturally, especially when it is caused by a temporary viral infection. However, even mild symptoms should be evaluated by a healthcare provider because untreated myocarditis can lead to serious complications.
Is myocarditis contagious?
Myocarditis itself is not contagious. However, some infections that can trigger myocarditis, such as COVID-19, influenza, or certain viral infections, can spread from person to person. Practicing good hygiene and avoiding contact with infected individuals may help reduce the risk.
How long does it take to recover from myocarditis?
Recovery time varies depending on the severity of the condition. Some people recover within a few weeks, while others may require several months. Individuals with severe myocarditis or complications such as heart failure may need long-term treatment and monitoring.
Can exercise make myocarditis worse?
Yes. Physical activity can place additional stress on an inflamed heart and may increase the risk of dangerous arrhythmias or worsening heart damage. Doctors often recommend avoiding strenuous exercise for several months until the heart has healed and medical testing confirms it is safe to resume activity.
Can children develop myocarditis?
Myocarditis can affect people of all ages, including infants, children, and teenagers. Symptoms in children may include rapid breathing, fatigue, poor feeding, abdominal pain, or irritability. Because symptoms can be nonspecific, prompt medical evaluation is important.
What foods should I avoid if I have myocarditis?
People with myocarditis are often advised to limit foods high in sodium (salt), as excessive sodium can worsen fluid retention and increase the workload on the heart. Processed foods, fast food, and salty snacks should be consumed sparingly. Your healthcare provider may recommend a heart-healthy diet tailored to your condition.
Can myocarditis cause permanent heart damage?
In some cases, yes. Severe or untreated myocarditis can leave scar tissue in the heart muscle, which may permanently affect the heart’s ability to pump blood efficiently. This can increase the risk of long-term complications such as cardiomyopathy, heart failure, or chronic arrhythmias. Early diagnosis and proper treatment can help reduce this risk. Ask your healthcare provider if you have additional questions.
