There are different causes of heart disease. Most heart diseases are caused due to high blood pressure which aids in the hardening of the arteries. The second major cause would be the high levels of bad cholesterol (LDL) in the arteries which result in arterial blockage. In the case of heart diseases affecting heart muscles, the heart muscles get stiff. This reduces the amount of pressure needed to expand or narrow the passage through which the blood flows. One such heart disease is Myocarditis. Myocarditis is caused due to the inflammation of the heart muscle called myocardium. Some of the common symptoms of this disease include chest pain, irregular or rapid heart rhythms, and shortness of breath. Viral infection is also the reason for the cause of myocarditis. The severe condition weakens the heart completely thereby the other organs won’t get enough blood.
Myocarditis Symptoms
Early myocarditis doesn’t have any symptoms in some people. Common myocarditis symptoms include:
- Fatigue
- Chest pain
- Shortness of breath
- Irregular heartbeat
- Inflammation in legs, ankles, and feet
- Dizziness
- Headache, joint pain, sore throat, or fever.
In some people, myocarditis symptoms are similar to that of a heart attack. If you get intolerable chest pain and shortness of breath, seek immediate medical help.
Causes of myocarditis
Certain viral infections, drugs, or any condition that creates whole-body inflammation are the causes of myocarditis.
Some potential causes may include:
- Viruses – Many viruses like adenovirus (common cold), COVID-19, parvovirus (causes a mild rash on the skin), hepatitis B and C, and herpes simplex virus are linked to the inflammation of heart muscles. Mononucleosis, echoviruses, and rubella (German measles) can also cause myocarditis. Myocarditis can also be caused by HIV which causes AIDS.
- Fungi – People with weakened immune systems are likely to attract fungal infections that may result in myocarditis. Such fungal infections include Aspergillus, Histoplasma (found in bird droppings), candida, and molds.
- Bacteria – Some bacteria that cause diseases like diphtheria and Lyme and staphylococcus and streptococcus can cause myocarditis.
- Parasites – Parasites transmitted by insects can cause Chagas disease. Chagas disease is more common in Central and South America than in the United States.
- Drugs – Antibiotics like sulfonamide and penicillin, anti-seizure medications, cocaine, and drugs that are used to treat cancer have an impact on causing heart muscle inflammation.
- Chemicals or radiation – Over-exposure to radiation and carbon monoxide can also cause inflammation in heart muscles.
How severe is myocarditis?
Mostly myocarditis goes away without any permanent complications. However, those with severe effects can permanently damage the heart muscle.
Risks include:
Heart failure – Untreated myocarditis can permanently damage the muscles in the heart which leads to poor pumping of blood to the heart and other parts of the body. This condition may require a heart transplant or ventricular assist device.
Heart attack or stroke – Injured heart muscles can’t pump blood out of the heart properly and this collected blood form clots. If in case, when this clot travels to an artery leading to the brain can cause a stroke.
Irregular heart rhythms – Damaged heart muscles cause rapid changes in the heart beats which certainly increases the risk of stroke.
Sudden cardiac death – Serious Arrhythmias (irregular heart rhythms) can make the heart stop beating all of a sudden. This could cause sudden cardiac arrest.
How to prevent myocarditis
There’s no specific prevention method to protect from myocarditis. However, protecting us from various infections might help prevent the disease.
- Avoid close contact with infected people – Stay away from people with symptoms of flu or other respiratory illness. Similarly, if you’re sick with a viral infection, it is good to avoid exposing others.
- Washing hands regularly – Frequent hand-washing is one of the best ways to stay away from various viral infections and spreading illnesses.
- Get vaccines – Get vaccines as recommended to protect against COVID-19, rubella, and influenza to prevent myocarditis. Talk to your medical practitioner to understand the benefits and risks of vaccines according to your age.
Diagnosis of myocarditis
To protect from long-term heart damage, it is important to do an early diagnosis. A typical examination procedure will include listening to your heartbeat with a stethoscope by your health care provider.
The following tests are done to confirm myocarditis and determine its severity.
- Blood tests – To determine the severity of infection and inflammation or to check for signs of a heart attack, your healthcare provider will recommend blood tests.
- ECG (Electrocardiogram) – This easy and painless test is carried out to determine how your heart beats. If there is a sign of irregular heartbeats (arrhythmias), then your healthcare provider will proceed with other tests to confirm myocarditis. Nowadays, a smartwatch can offer electrocardiogram monitoring. Consult with your doctor, to know if this is an option for you.
- Cardiac MRI – This test uses radio waves and magnetic fields to produce detailed images of the heart. This result shows the size, shape, and structure of the heart. From this, we can find heart muscle inflammation.
- Echocardiogram – Here, sound waves are used for creating images of the heartbeat. This also shows how well blood flows through the heart valves. Echocardiogram is useful to determine the presence of any unwanted fluid around the heart.
- Cardiac catheterization – A catheter (thin tube) is threaded through a blood vessel in the arm or groin to an artery in the heart. This tube helps identify the issues more clearly on X-rays.
- Heart muscle biopsy – During the cardiac catheterization method, a tiny sample of heart muscle tissue is taken and sent to a lab to be diagnosed for infection or inflammation.
Treatment
Some people with mild myocarditis may require medications only for a few months and then recover completely. People with severe or permanent heart muscle damage may require life-long medication. Therefore, it’s important to have regular checkups with your healthcare provider to check for possible complications.
Surgeries
Severe myocarditis needs aggressive treatment procedures which include:
- Ventricular assist device (VAD) – this helps in pumping blood from the ventricles (lower chambers of the heart) to the rest of the body. VAD is commonly used to help the heart work while undergoing other treatments like heart transplants.
- IV medications – Some medications are given through an IV to quickly improve the heart’s ability to pump blood effectively.
- Extracorporeal membrane oxygenation – ECMO is a machine that works similarly to the lungs. This helps to add oxygen to the blood and removes carbon dioxide. During ECMO, blood is removed from the body, passed through the machine, and then returned to the body. This procedure is widely used during heart transplantation.