Is myocarditis serious?

Written by Xiao Chang Jiang
Cardiology
Updated on September 18, 2024
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Is myocarditis serious? In fact, myocarditis is an inflammatory disease of the myocardium. Patients with myocarditis may experience symptoms such as fatigue, palpitations, shortness of breath, discomfort or pain in the precordial area, nausea, vomiting, abdominal pain, diarrhea, etc. During examinations, we often see slight enlargement of the heart, arrhythmias, gallop rhythm, and other manifestations of heart dysfunction. In severe cases, myocarditis can lead to fulminant myocarditis, such as severe heart failure or cardiogenic shock, often accompanied by arrhythmias. Even with timely and standard treatment, death may occur due to the severity of the condition. Even if patients with myocarditis recover, they may still have some sequelae on the electrocardiogram, such as atrioventricular block, bundle branch block, premature beats, or junctional rhythm.

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How is myocarditis diagnosed?

The examination of myocarditis includes several aspects: First, the biochemical blood test shows that white blood cells can increase, erythrocyte sedimentation rate can accelerate, and both cardiac enzymes and troponins can rise. There may also be abnormalities in the electrocardiogram, such as arrhythmias or ST-segment changes. In addition, there are X-ray examinations, which can show an enlarged heart shadow or pulmonary congestion. Echocardiograms may not show any specific changes or can exhibit phase-dependent or regional abnormalities in ventricular wall motion. Furthermore, nuclear imaging and magnetic resonance imaging indicate the presence of fluttering and inflammatory changes. The virological examination can isolate the virus through throat swabs or stool samples, and if necessary, an endocardial or myocardial biopsy can be performed.

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How is myocarditis cured?

Myocarditis often has a self-limiting course, and viral infection is a common cause of myocarditis. Currently, there is no specific treatment for viral myocarditis. Treatments are divided into two main categories: general treatment, primarily consisting of rest. Generally, patients should rest in bed for more than three months, while also paying attention to their diet by eating easily digestible foods rich in vitamins and proteins. The second category is drug treatment, which mainly supports heart function. In cases of heart failure, diuretics, vasodilators, and ACE inhibitors should be administered. For arrhythmias, anti-arrhythmic treatment is necessary. If viral myocarditis is confirmed, antiviral treatment should be given. Additionally, drugs that enhance myocardial metabolism, such as cyclic adenosine monophosphate, coenzyme A, or adenosine triphosphate, should also be used. (Specific medication use should be conducted under the guidance of a doctor.)

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Criteria for Diagnosing Myocarditis

The diagnosis of myocarditis is primarily clinical, based on typical precursor symptoms, corresponding clinical manifestations, and physical signs. The precursor symptoms usually occur one to three weeks before the onset, including symptoms of a viral infection such as fever, general fatigue, and muscle soreness, or gastrointestinal symptoms like nausea and vomiting. Subsequently, symptoms such as chest tightness, palpitations, difficulty breathing, and even fainting and sudden death may occur. The physical signs generally include arrhythmias, commonly premature atrial contractions, premature ventricular contractions, or conduction blocks. There may be an increased heart rate which does not correspond to the body temperature, and there could be the presence of second or third heart sounds or gallop rhythm. A minority of patients may show signs of heart failure. Tests can include electrocardiograms, enzymatic studies, or echocardiograms, and magnetic resonance imaging may show symptoms of myocardial injury. To confirm the diagnosis, an endomyocardial biopsy must be performed.

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Is myocarditis cough severe?

Patients with myocarditis often exhibit early symptoms such as fever, cough, difficulty breathing, fatigue, and in severe cases, chest tightness and shortness of breath, even leading to shock or death, and syncope. Typically, the cough is not too severe, but if myocarditis is suspected, the patient should go to the hospital for timely diagnosis. Primary diagnostic tests include electrocardiogram, myocardial enzymes, and cardiac ultrasound. Once diagnosed, hospitalization for immediate treatment is necessary to prevent the condition from worsening. Because fulminant myocarditis can lead to death within days from minor symptoms, all myocarditis patients should be treated as severe cases and not be neglected.

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What should be avoided in the diet for myocarditis?

Myocarditis is an inflammatory disease of the myocardium. Currently, there is no specific treatment for myocarditis. Patients should avoid fatigue, rest adequately to reduce cardiac load, and pay attention to nutritional intake. It is encouraged to eat easily digestible foods that are rich in vitamins and high in protein, and to avoid spicy, greasy, and hard-to-digest foods. Additionally, it is advisable to consume more fruits and vegetables, which are rich in vitamin C.