Myocarditis—Adult

Definition

Myocarditis is an inflammation of the heart’s muscular wall, the myocardium. Although rare, it can be devastating. Myocarditis can occur with no symptoms and remain undiagnosed.
Healthy Myocardium
normal heart section
Copyright © Nucleus Medical Media, Inc.

Causes

Many cases of myocarditis have no identifiable cause. This is called idiopathic myocarditis. When a cause is identified, it falls into one of 3 categories:
  • Infectious—bacterial, viral, or fungal
  • Toxic—medications, or exposure to heavy metals, toxins, or physical agents (shock, radiation)
  • Immune-mediated—allergic reactions, heart transplant rejection, or autoantigens (which may be present in autoimmune disorders)

Risk Factors

There are no known risk factors for developing myocarditis.

Symptoms

Some people have no symptoms of myocarditis. In those that have them, symptoms can vary from person-to-person depending on the cause and the severity. Symptoms may appear slowly or come on suddenly.
  • Flu-like complaints, including fever, fatigue, muscle pain, vomiting, diarrhea , and weakness
  • Rapid or irregular heart rate
  • Chest pain
  • Shortness of breath and respiratory distress
  • Loss of consciousness
  • Sudden, unexpected death
Sudden, intense myocarditis can lead to heart failure .

Diagnosis

The diagnosis of myocarditis is often difficult. There is no specific test for it. Many other causes of heart problems must be ruled out. To do this, your doctor will ask about your symptoms and medical history. A physical exam will be done.Tests may include:
  • Blood tests to look for specific cardiac enzymes
  • Electrocardiogram (EKG)—records the heart’s activity by measuring electrical currents through the heart muscle
  • Chest x-ray
  • Biopsy —removal of a sample of heart tissue to test for infection
Imaging tests evaluate the heart and surrounding structures:

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