Myocarditis is characterized by the inflammation and damage to the heart muscle. It can develop as the result of various causes such as a viral infection and from adverse reactions to certain medications. It can affect the muscle cells and the electrical system of the heart which can cause its reduced function and irregular heart rhythms. The chronic heart failure is considered to be one of the major complications. When the condition becomes severe, the heart cannot effectively supply blood to the rest of the body. Blood clots can also develop in the heart causing a heart attack or stroke. When this condition affects children, it is known as pediatric myocarditis.
Causes
This is an uncommon condition that mostly develops as the result of an infection that reaches the heart. The body’s immune system produces cells to fight off infections. When the infection affects the heart, these special infection-fighting cells enter the heart and damage the heart muscle causing them to become swollen and weak. The scar tissue can develop from the inflammation affecting its normal function and increasing the risk of abnormal heart rhythms. Some of the microbes that cause myocarditis include varicella (chickenpox), adenovirus (common cold), influenza, Epstein-barr virus, streptococcus, chlamydia, candida and HIV. Myocarditis can also develop because of exposure to certain chemicals, chemotherapy drugs and diseases such as lupus, giant cell arteritis and takayasu’s arteritis.
Symptoms
The mild cases of this condition may not present any evident symptoms except for the general symptoms associated with the viral infection. However, the common symptom of this condition is the shortness of breath with physical exertion. The symptoms mostly develop around 7 to 14 days after the viral infection. Additional symptoms can include heart palpitations, chest pain or pressure, fatigue and swelling of the legs. The affected children can present fever, fainting, abnormal heart rhythms and breathing difficulties.
Diagnosis
There isn’t a single test to determine myocarditis. However, various tests may be required to confirm the diagnosis which can include a chest x-ray, electrocardiogram recording the electrical activity of the heart, cardiac MRI to determine heart abnormalities and cardiac catheterization to evaluate the pressure within the heart. The blood tests can measure the quantity of white and red blood cells including the levels of various enzymes which can indicate heart muscle damage. The blood test can also identify the antibodies against the infection which can be an indication of myocarditis-related infection. In some cases, a biopsy of the heart tissue may be required for a definitive diagnosis.
Treatment
In most cases, myocarditis can improve with or without the need for a treatment. Antibiotics may be necessary if bacteria is the cause of an infection. Treatments may also consist of medications to regulate the heartbeat and to reduce the risk of blood clots developing in the heart. In the case of a weak heart, medications may be prescribed to reduce the workload of the heart and to remove the excess fluid. In the severe cases, other treatments can include intravenous medications to improve pumping function of the heart, ventricular assist devices, intra-aortic balloon pump to increase blood flow and decrease the workload on the heart.
References
http://www.mayoclinic.org/diseases-conditions/myocarditis/basics/treatment/con-20027303
https://medlineplus.gov/ency/article/000149.htm
https://www.myocarditisfoundation.org/about-myocarditis/
http://www.chop.edu/conditions-diseases/myocarditis
