Myocarditis

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Myocarditis
Micrograph of viral myocarditis.
Synonyms	Inflammatory cardiomyopathy
Pronounce	N/A
Specialty	N/A
Symptoms	Chest pain, shortness of breath, fatigue, arrhythmias
Complications	Heart failure, sudden cardiac death
Onset	Variable
Duration	Variable
Types	N/A
Causes	Viral infection, bacterial infection, autoimmune disease, toxins
Risks	Viral infections, autoimmune disorders, toxic substances
Diagnosis	Electrocardiogram, blood tests, cardiac MRI, endomyocardial biopsy
Differential diagnosis	Acute coronary syndrome, pericarditis, cardiomyopathy
Prevention	N/A
Treatment	Medications, supportive care, heart transplant
Medication	ACE inhibitors, beta blockers, diuretics
Prognosis	Variable; can be self-limiting or lead to chronic heart failure
Frequency	Rare
Deaths	N/A

Myocarditis is inflammation of the heart muscle.

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.

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