How is myocarditis diagnosed?

Written by Zhou Yan
Geriatrics
Updated on September 23, 2024
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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 Tang Li
Cardiology
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What are the symptoms of myocarditis?

The clinical manifestations of myocarditis in patients depend on the extent and location of the lesion. Mild cases may have no symptoms at all, while severe cases can even present with heart failure and shock. Most patients have precursor symptoms of viral infection one to three weeks before the onset, such as fever, general fatigue, and muscle soreness. Some patients have gastrointestinal symptoms like nausea and vomiting. Subsequently, they may experience palpitations, chest pain, breathing difficulties, edema, and even fainting or sudden death. The majority of clinically diagnosed myocarditis cases primarily present with or are primarily symptomatic of psychological frailty. A minority of patients may experience fainting or Aschner's syndrome as a result.

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Written by Chen Si
Pediatrics
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Is pediatric myocarditis serious?

The severity of myocarditis in children needs to be assessed by considering the child's clinical symptoms and corresponding clinical examinations comprehensively. Common clinical symptoms include chest tightness, fatigue, shortness of breath, etc. Most children have a history of upper respiratory tract infection before the symptoms appear. It is necessary to conduct routine blood tests, myocardial enzymes, troponin, myocardial antibodies, viral antibodies, electrocardiograms, and other relevant physicochemical examinations to further clarify the condition. Patients with mild symptoms and roughly normal laboratory results can improve on their own with rest. If there are clinical symptoms such as chest tightness, fatigue, shortness of breath, and related physicochemical examinations show abnormal changes, it is necessary to use medication to nourish the myocardium. During treatment, rest is advised, reduce fatigue, maintain emotional stability, and generally, the symptoms can improve within 10 to 15 days. For more severe cases, the treatment period may need to be extended accordingly.

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Written by Xiao Chang Jiang
Cardiology
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Is myocarditis serious?

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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Written by Tao Kun
Geriatrics
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Difference between myocarditis and myocardial injury

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 Zhou Yan
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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.