India has the most number of cardiovascular diseases, owing to an unhealthy and sedentary lifestyle. One such condition is myocarditis.
There comes a time when all should sit and think about the various heart conditions we are exposing ourselves to. With the rising cases of cardiovascular diseases in India, there are certain heart conditions that are not widely known. Heart disease is a group of conditions that affect the heart and blood cells. In 2016, around 17.9 million people worldwide succumbed to death due to heart diseases. According to the report, "The Global Burden of Disease Study Changing Patterns of Heart Disease and Their Risk Factors in the States of India 1990-2016", heart disease killed approximately 2.8 million people in India in 2016. This is higher than the 1.5 million deaths in 1990.
One of the lesser-known heart conditions that we will be talking about in this article is myocarditis, which is inflammation of heart muscles. Dr Santosh Kumar Dora, Senior Cardiologist, Asian Heart Institute, Mumbai tell us all about myocarditis, a disease that causes inflammation of the heart muscle.
Causes of Myocarditis
Myocarditis is caused by exposure to certain viruses, bacteria, parasites, toxins or drugs. It also can happen due to autoimmune activation against self antigens. Viruses are by far the most common infective cause of myocarditis.
Symptoms of Myocarditis
The symptoms of myocarditis are as follows:
- Chest pain
- Heaviness in chest
- Difficulty in sleeping
If myocarditis has led to severe dysfunction of the heart muscle, then the patient presents with heart failure. In heart failure, the patient may have severe breathlessness even at rest, not able to lie down, swelling in ankle because of fluid retention, etc. Myocarditis also can cause heart rhythm disorders leading to palpitation, black out and in very severe cases syncope and cardiac arrest.
Diagnosis of Myocarditis
Specific diagnosis is done from endomyocardial biopsy, however due to invasiveness of the procedure, it is less often done. Cardiac biomarkers like Trop I and CPK MB increase during episode of myocarditis. Cardiac MRI can help diagnosing myocarditis, which is noninvasive. ECG and 2D echocardiogram are also commonly done investigations. Echocardiogram shows the efficiency of heart muscle and valve functionality.
Treatment of Myocarditis
Myocarditis treatment is mostly supportive. Most cases of viral myocarditis will have spontaneous recovery of heart pumping function. However, sometimes there may be persistent low pumping or progressive deterioration of heart’s pumping function. Such cases will need medication for improving pumping, decreasing stress on the heart, increasing urine output etc. In severe cases, mechanical circulatory help devices may be needed to aid heart function. In severe cases heart transplant may be warranted. Some cases may need AICD implantation to protect from sudden cardiac arrest.
Can it be Prevented?
Influenza vaccine gives some protection from viral infection and thus protects from myocarditis. Ideally everybody should take flu vaccine every year before winter. Drugs and toxins like cocaine can cause myocarditis. So, these kind of pleasure drugs should be strongly avoided. Excess alcohol can weaken heart muscle and can give rise to cardiomyopathy. Thus, excess alcohol drinking should be avoided.
Healthy habits like regular physical exercise, avoidance of smoking, healthy diet, chosing the right cooking oil, with lots of fruits and vegetables stimulate immune system and develops immunity to most of the viruses responsible for myocarditis.
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