Myocarditis: Causes, Symptoms and Treatment

Myocarditis, also known as inflammatory cardiomyopathy, is inflammation of the heart muscle (myocardium). The myocardium is the muscular wall of the heart, or the heart muscle. It contracts to pump blood out of the heart and then relaxes as the heart refills with returning blood. The myocardium’s smooth outer membrane is called the epicardium. Its inner lining is called the endocardium.

When the heart becomes inflamed, it cannot pump as well because of damage to its cells and swelling (edema). More often, the heart tries to heal itself by changing the damaged or dead heart muscle cells into scar tissue. Scar tissue is not like heart muscle tissue because it does not contract and it cannot help the heart to pump. If enough scar tissue forms in the heart, it can lead to congestive heart failure or dilated cardiomyopathy.




Myocarditis is a rare condition. The inflammation of the heart muscle may be caused by:

  • A viral, bacterial, or fungal infection.
  • Rheumatic fever, which can occur if the antibodies that your body sends to fight a strep infection attack the tissues of your joints or heart instead.
  • Drug or chemical poisoning.
  • Connective tissue diseases, such as lupus or rheumatoid arthritis.



If you have a mild case of myocarditis or are in the early stages, you might have no symptoms or mild ones. You may have a fever, an achy feeling in your chest, and severe fatigue, as if you have a bad cold or flu. Some people have an irregular heartbeat (arrhythmia) or trouble breathing, such as chest pain or shortness of breath.In serious cases, the signs and symptoms of myocarditis vary, depending on the cause of the disease. Common myocarditis signs and symptoms include:








Myocarditis is hard to diagnose because it can resemble many other diseases. Your doctor may suspect that you have myocarditis if your symptoms have appeared within 6 months of having an infection. A number of tests may be used to confirm the diagnosis:

  • With a stethoscope, doctors can listen for a rapid heartbeat (called tachycardia).
  • Blood tests to check for recent infection or signs of inflammation in the body.
  • A chest x-ray can show doctors if there is a buildup of fluid in the lungs (called pulmonary edema). This is one of the signs of heart failure.
  • Electrocardiography (an ECG or EKG) can help doctors learn more about your heart rhythm and the size and function of the chambers of your heart.
  • Echocardiography can be used to see heart wall motion and overall heart size.
  • A tiny sample of the heart muscle can be removed using a special device called a bioptome. This procedure is called an endomyocardial biopsy. The sample can then be tested for signs of infection.



Myocarditis is commonly treated with medications used to treat heart failure, such as digoxin and diuretics. Steroids and other medications also may be used to reduce heart inflammation.

Some lifestyle changes and recommendations that can be added to the treatment of myocarditis are rest and low salt intake.Rarely, if an abnormal heart rhythm is present, treatment may require additional medications and surgery, including a pacemaker or even a defibrillator.









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