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What is myocarditis?
Myocarditis, also known as myocarditis, is an inflammation of the heart muscle that can affect the heart's ability to pump blood effectively. The inflammation is most often caused by viral infections but can also occur as a result of bacteria, autoimmune diseases, or certain medications. The condition can range from mild symptoms to serious complications such as heart failure or heart rhythm disorders.
Causes of myocarditis
Myocarditis can occur for several reasons, with viral infections being the most common:
- Viral infections: Most common cause, such as enterovirus (coxsackievirus), influenza virus or COVID-19.
- Bacterial infections: For example, streptococci or Lyme disease (in Lyme disease).
- Autoimmune diseases: Rheumatoid arthritis or lupus can cause myocarditis.
- Drugs and toxins: Certain medications or heavy alcohol use can affect the heart muscle.
- Vaccinations: Myocarditis has been reported in rare cases after vaccination, especially in young men.
Symptoms of myocarditis
Symptoms in myocarditis can vary depending on how much the heart is affected. Common signs include:
- Chest pain: Often similar to a heart attack, with a sharp, squeezing or squeezing sensation in the chest.
- Shortness of breath: Especially with physical exertion, but in more severe cases even at rest.
- Fatigue: Noticeable lack of energy that is out of proportion to activity.
- Heart palpitations: Sensation of a fast, irregular or pounding heartbeat.
- Dizziness or fainting: Signs of impaired blood flow from the heart.
- Fever and muscle aches: Common with concurrent or previous infection.
When should you seek medical attention?
It is very important to seek medical attention if you suspect myocarditis. Seek immediate medical attention if:
- Persistent or acute chest pain that does not go away at rest.
- New onset of breathing difficulties or swelling in the legs.
- Palpitation or feeling faint.
- New onset of heart symptoms in connection with or after an infection.
Diagnosis and blood tests for myocarditis
The diagnosis is made using symptoms, heart examinations and blood tests:
- ECG: Can show rhythm disturbances or signs of inflammation and muscle damage.
- Blood tests: Troponin (cardiac marker for damage to heart muscle cells), CRP (inflammation marker) and BNP (used if heart failure is suspected).
- Ultrasound of the heart (echocardiography): Assesses the structure and pumping ability of the heart.
- MRI heart: Used to confirm the diagnosis and map the spread of inflammation in the heart muscle.
Treatment of myocarditis
Treatment depends on the cause and severity of the inflammation:
- Strict rest: Physical rest is the most important measure to reduce the strain on the heart. Exercise and strenuous physical exertion should be avoided during the acute phase and often for several months afterward.
- Important about anti-inflammatory treatment: Traditional anti-inflammatory drugs (NSAIDs, e.g. ibuprofen) should not be used in pure myocarditis, as they can worsen the damage to the heart muscle. However, if there is concomitant inflammation of the pericardium (pericarditis), anti-inflammatory treatment may be indicated after the doctor's assessment.
- Treatment of the underlying cause: For example, antibiotics for bacterial infection or targeted treatment for autoimmune disease.
- Heart failure and rhythm treatment: In cases of reduced pumping ability or rhythm disorders, medical heart failure treatment is given (such as ACE inhibitors or beta blockers).
Frequently asked questions and answers about myocarditis
How does myocarditis feel?
Myocarditis is often felt as chest pain, pressure or discomfort in the chest. Many people also experience severe fatigue, palpitations, and shortness of breath, especially during exercise.
How do you get myocarditis?
The most common cause is that the immune system reacts to a viral infection (such as a cold, flu, or stomach bug), which triggers inflammation of the heart muscle. It can also occur as a result of bacteria, autoimmune reactions, or certain medications.
How do you know if you have myocarditis?
If you have or have recently had an infection and then develop chest pain, fatigue, or shortness of breath, you should seek medical attention. Your doctor can diagnose the condition through an EKG, blood tests (such as troponin), and ultrasound or MRI of the heart.
How does myocarditis start?
It often starts with a completely common infection, such as a sore throat, cold, or flu. After a few days or weeks, symptoms from the heart appear, such as chest pain, irregular heartbeat, or unexplained shortness of breath.
