Myocarditis is a condition characterised by inflammation of the heart muscle (myocardium). It can affect people of all ages and may range from mild cases with minimal symptoms to severe cases that can lead to heart failure. Understanding the symptoms, causes, and treatment options for myocarditis is crucial for timely diagnosis and effective management.
“If myocarditis has caused substantial malfunction of the heart muscle, the patient will present with heart failure. Patients with heart failure may have extreme dyspnea even at rest, inability to lie down, swelling in the ankle due to fluid retention, and so on. Myocarditis can also induce heart rhythm problems, such as palpitations, blackouts, and, in extreme situations, syncope and cardiac arrest,” said Dr Santosh Kumar Dora, Senior Cardiologist, Asian Heart Institute, Mumbai.
Symptoms of Myocarditis
One of the main symptoms of myocarditis is unexplained chest pain or discomfort is a common symptom. Including Persistent fatigue and weakness, even with minimal physical exertion. Difficulty breathing, especially during activity or while lying down. Individuals suffering from this condition may feel palpitations, a fluttering sensation, or irregular heart rhythms. Also, fluid retention leads to swelling in the legs, ankles, or abdomen. Myocarditis may present with fever, body aches, and flu-like symptoms.
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Causes of Myocarditis
Most commonly caused by viral infections, such as enteroviruses (coxsackievirus), adenovirus, or the Epstein-Barr virus.
- Bacterial or Fungal Infections: Infections caused by bacteria or fungi can also lead to myocarditis.
- Autoimmune Diseases: Conditions where the immune system mistakenly attacks the heart muscle
- Toxins and Chemicals: Exposure to certain toxins, drugs, or chemicals can trigger inflammation.
- Certain Medications: Some medications, such as certain antibiotics or antipsychotics, may increase the risk.
- Other Infections: Parasitic or protozoal infections can contribute to myocarditis in some cases.
Diagnosis
- Physical Examination: A doctor will assess symptoms and perform a physical examination.
- Blood Tests: Elevated levels of cardiac enzymes or inflammatory markers may indicate myocarditis.
- Electrocardiogram (ECG or EKG): Measures the heart's electrical activity to identify irregularities.
- Echocardiogram: Uses sound waves to create images of the heart, assessing its structure and function.
- Cardiac MRI or CT Scan: Provides detailed images of the heart to detect inflammation.
- Endomyocardial Biopsy: Rarely performed but may be done to confirm the diagnosis by examining a small heart tissue sample.
Treatment
Mild cases may require only supportive care, rest, and over-the-counter pain relievers. Otherwise following treatment plan is followed.
- Medications: Anti-inflammatory medications (such as NSAIDs) or immune-suppressants may be prescribed.
- Diuretics: To manage fluid retention and swelling.
- Antibiotics or Antivirals: If the cause is bacterial or viral, specific medications may be prescribed.
- Heart Failure Medications: In severe cases leading to heart failure, medications to support heart function may be necessary.
- Lifestyle Modifications: Rest, avoiding strenuous activity, and maintaining a heart-healthy lifestyle.

Prevention
Keeping vaccinations up-to-date can prevent some viral infections associated with myocarditis. Practising good hygiene, especially handwashing, can reduce the risk of viral infections. Minimising exposure to toxins and chemicals.
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Myocarditis is a serious condition that requires prompt diagnosis and appropriate treatment. If experiencing symptoms like chest pain, shortness of breath, or fatigue, it's essential to seek medical attention. Understanding the potential causes and taking preventive measures can contribute to reducing the risk of myocarditis. Always consult with healthcare professionals for personalised advice and guidance.