Difference between myocarditis and myocardial injury

Written by Tao Kun
Geriatrics
Updated on September 05, 2024
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Myocarditis is inflammation of the myocardial cells caused by a virus that has not been timely cleared following a respiratory or gastrointestinal viral infection. It is a term used for disease diagnosis.

Myocardial injury, on the other hand, refers to the necrosis of myocardial cells due to various factors, including viral myocarditis and myocardial ischemia caused by the narrowing of coronary arteries. Therefore, myocardial injury is a state diagnosis, not a term used for disease diagnosis. Myocardial injury usually leads to elevated levels of troponin.

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Written by Yan Xin Liang
Pediatrics
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Do children with myocarditis have a fever?

In general, viral myocarditis is the most common form of myocarditis in children. This condition can be caused by various viruses such as influenza, parainfluenza, Coxsackie virus, adenovirus, etc., affecting the pediatric cardiac muscle tissue, which in turn can lead to symptoms of myocarditis. Since it is an infectious disease, fever is a common symptom. Fevers associated with myocarditis might present as high or moderate. Treatment primarily focuses on cardiac recovery, nourishing the cardiac muscle, steroids, and immunoglobulins, among others. Severe myocarditis is a critical condition that requires timely diagnosis and treatment to avoid worsening the situation.

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Written by Zhou Yan
Geriatrics
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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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Written by Zhou Yan
Geriatrics
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Manifestations of myocarditis

Myocarditis is an inflammatory disease of the myocardium. Its manifestations depend on the extent and location of the condition; mild cases may have no symptoms, while severe cases can lead to cardiogenic shock and sudden death. Most patients experience precursor symptoms of viral infection one to three weeks before onset, such as fever, general fatigue, and muscle soreness, or gastrointestinal symptoms like nausea and vomiting. Subsequently, they may experience palpitations, chest tightness, difficulty breathing, and potentially fainting or sudden death. Clinically diagnosed myocarditis is mostly due to arrhythmias as the primary complaint, or patients seek treatment for common symptoms.

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Written by Zhou Yan
Geriatrics
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The dangers of myocarditis

Myocarditis is an inflammatory disease of the myocardium. Most cases of myocarditis are self-limiting, but if not treated promptly, it can progress to dilated cardiomyopathy. Dilated cardiomyopathy often begins insidiously. Once symptoms appear and the patient enters the stage of heart failure, the condition becomes very serious. Additionally, a minority of patients experience a fulminant onset, leading to acute decompensation or sudden death. Fulminant myocarditis and severe myocarditis progress quickly and have a high mortality rate, thus highlighting the dangers of myocarditis.

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Written by Zhou Yan
Geriatrics
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How is myocarditis detected?

The diagnosis of myocarditis includes several aspects: The electrocardiogram may show STT changes, or various arrhythmias. Chest radiography may reveal an enlarged cardiac silhouette, while an echocardiogram may be normal or show left ventricular enlargement. Magnetic resonance imaging may show myocardial edema or congestion. Biochemical examinations may reveal elevated levels of troponin and myocardial enzymes, as well as increased erythrocyte sedimentation rate and C-reactive protein. Additional diagnostic methods include etiological examinations, which can identify viral infections through blood or stool samples. Furthermore, endocarditis or myocardial biopsy can provide definitive diagnosis.