Myocarditis refers to inflammation of the heart muscle, the myocardium. The condition is usually benign, but it can take many forms and have different manifestations. Sometimes, symptoms are not felt and the condition can go untreated. In this case, severe heart failure may occur. To avoid further complications, it is important to have appropriate management and medical supervision.
Definition
The myocardium is a muscle that contains specific cells. These cells can contract just like muscle cells, and also conduct electricity to cause a contraction. The heart is only 300g in adult weight, but it consumes 10% of our body’s oxygen. The myocardium is an internal hollow muscle that is about the same size as a fist. It is covered by two protective membranes, the epicardium and the endocardium.
There are 4 chambers in the heart that work together. There are two types of hearts: a right and left. Each pair is composed of the atrium, a chamber that receives blood, and contracts to release it into the ventricle, a second chamber. After contracting, the ventricle is bigger and expels blood into an arterial. Each compartment is separated by “cardiac valves”, which allow for one-way blood flow.
A good synchronisation between the various contractions in your heart is essential for blood circulation.
Low Oxygen Blood
Low oxygen blood (which has been used to supply oxygen to our bodies) is transported to the right atrium. It then travels to the right ventricle, where it is propelled through the lung artery to the lungs. This is where the nerve signal that triggers the electrical impulses that regulate the heart’s contraction is found.
After passing through the lungs, oxygenated blood arrives at the left heart and is propelled throughout the body by the aorta.
What is Myocarditis?
Myocarditis refers to inflammation of the myocardium (the muscle tissue within the heart). There are many causes for inflammation, including flu, mumps, and viral infections. Myocarditis can also occur from a variety conditions, such as:
- Certain infectious diseases (e.g. Diphtheria and Lyme diseases (e.g.
- Rheumatic fever is a serious complication from strep.
- Certain drugs (e.g. Some anti-cancer drugs, known as hypersensitivity myocarditis.
- Radiotherapy.
- Some autoimmune diseases (e.g. Systemic lupus, erythematosus).
- There are many toxic substances, including cocaine and alcohol.
Myocarditis may lead to heart failure. The heart can become damaged and no longer functions properly as a pumping device. It is also less able to maintain good blood flow. The heart’s ability to pump blood decreases as it gets older. This causes a decrease in blood supply to all organs.
Signs
Myocarditis can be silent in some patients and may not cause any symptoms. Some patients may develop rapidly progressive heart disease with severe rhythm disturbances. The symptoms are largely dependent on the source of myocarditis as well as the severity of the inflammation. Heart failure can be described clinically as fatigue, shortness or oedema. Palpitations may be experienced by some patients.
Infectious myocarditis can cause other symptoms, similar to the flu, such as fever, muscle pains, headaches, diarrhoea and sore throats.
A skin rash may also be associated with hypersensitivity or drug-induced myocarditis.
Myocarditis can also be associated with inflammation of myocardium (or Pericarditis). This may cause more or less severe chest discomfort. The pain can radiate to the neck or back, as well as the shoulders. When the patient coughs or swallows food, it can aggravate the pain. The pain can be decreased if the patient sits or bends forward.
Arrhythmia, which is the inability to control the heartbeat, can be a sign of severe myocarditis. Heart rhythm disorders are when the heart beats too fast, irregularly, or is short, fatigue, or oedema in the lower limbs.
Diagnosis
After carefully examining the patient, the doctor recommends myocarditis. The doctor will first perform a clinical exam, as with all diagnoses. If he suspects that he has myocarditis, a clinical examination may be required. This includes an electrocardiogram (or ECG), blood samples (to determine the level of certain cardiac markers), and an echocardiogram.
Treatment
Myocarditis can be self-limiting in most cases. Some forms of myocarditis can cause severe complications and even lead to death. This condition can be treated by addressing its root cause.
Myocarditis treatment begins with rest and ceasing all physical exertion. Due to the increased risk of developing heart rhythm disorders, hospitalization is sometimes necessary. Treatment with medication can be considered. For myocarditis due to an autoimmune condition, corticosteroid treatment and immunosuppressive therapy may be considered. In the event of a heart rhythm disorder, the doctor may recommend anti-arrhythmic medications (including beta-blockers). A pacemaker can be placed if rhythm abnormalities continue. Antibiotics can be used if there is an infection.
A heart transplant is an option if all other treatments fail.
If the patient is an athlete, a cardiologist will approve the patient’s return to intense exercise. You should do this slowly.
Prevention
There are many causes of myocarditis, some of which can be avoided. Myocarditis can be prevented by vaccinations against tuberculosis and influenza. Consumption of toxic substances such as cocaine and influenza should also be avoided.
Additionally, it is important to avoid intense sports during a fever or the week after an influenza episode (fever that causes aches and pains).
