Myocarditis is a disease characterized by inflammation of the heart muscle, called myocardium, the muscular layer of the heart wall. This muscle is responsible for contracting and relaxing to supply blood to the heart and body and the rest of the body.
When this muscle is inflamed, the ability to pump blood becomes less effective. It can cause problems such as abnormal heartbeats, chest pain, or shortness of breath. In severe cases, it can lead to blood clots, heart failure or heart damage or death, which can lead to a heart attack or stroke.
In general, inflammation is a physical response to any type of injury or infection. Hold down g when you cut your finger: in a short time, the tissue around the cut swells and turns red, which are classic signs of inflammation. Your body's immune system goes to the wound site and produces specialized cells to carry out repairs.
But sometimes another cause of inflammation or inflammation of the immune system can lead to myocarditis.
What are the symptoms?
The danger about myocarditis is that it can affect anyone, it can occur at any age, and it can continue without having any symptoms. If symptoms do develop, they are similar to symptoms experienced with the flu, namely:
Fatigue
Difficulty breathing
Fever
Joint pain
Swelling of the lower extremities.
Feeling pain in the chest.
Most of the time, myocarditis goes away on its own without treatment, and the incision in your finger will eventually heal. Even some cases that last a long time do not cause symptoms of sudden cardiac arrest.
But secretly, they can damage the heart muscle, where heart failure symptoms appear slowly over time. In other cases, the heart reveals its problems faster with symptoms such as chest pain, shortness of breath, palpitations and cardiac arrest.
What Causes Myocarditis?
In most cases, the exact cause of myocarditis has not been found. When the cause of myocarditis is found, it is usually a viral infection (common) or an infection of the heart muscle that leads to a bacterial, parasitic, or fungal infection.
When you try to get an infection, the immune system fights back, trying to get out of the disease. This leads to an inflammatory response that weakens the heart muscle tissue. Some autoimmune diseases, such as lupus (SLE), cause the immune system to switch against the heart, causing inflammation and damage to the heart muscle.
It is difficult to determine the exact cause of myocarditis, but the possible culprits are as follows.
Virus
According to the Myocarditis Foundation, viruses are one of the most common causes of infective myocarditis. The most common viruses that cause myocarditis are group B coxsackie virus (an enterovirus), human herpesvirus 6, and parvovirus B19 (which causes fifth disease).
Other possibilities include echovirus (which causes gastrointestinal infections), Epstein-Barr virus (which causes infectious mononucleosis), and rubella virus (which causes German measles).
Bacteria
Myocarditis can also be caused by infection with Staphylococcus aureus or Corynebacterium diphtheriae. Staphylococcus aureus is a bacterium that causes inflammation and is a strain resistant to methicillin (MRSA). Corynebacterium diphtheriae is a bacterium that causes diphtheria, destroying the tonsils and cells in the throat.
Mushrooms
Yeast, mold, and other fungal infections can sometimes cause myocarditis.
Parasites
Parasites are microorganisms that are shed from organisms. They can also cause myocarditis. It is very rare in the United States, but more common in Central and South America (where the parasitic trypanosome causes a condition called Cruzi Chagas disease).
Autoimmune diseases
Myocarditis can sometimes be caused by autoimmune diseases that cause inflammation in other parts of the body, such as rheumatoid arthritis or SLE.
Myocarditis sometimes also occurs if you are exposed to:
Drugs or illicit drugs that cause an allergic or toxic reaction. These include drugs used to treat cancer; Antibiotics such as penicillin and sulfonamide; Some anticonvulsant medications; And some illicit substances like cocaine.
Chemicals or radiation. Exposure to certain chemicals, such as carbon monoxide and radiation, can sometimes cause myocarditis.
Other diseases. These include disorders such as lupus, Wegener's granulomatosis, giant cell arteritis, and Takayasu arteritis.
How is it diagnosed?
Although diagnosing myocarditis is difficult, your cardiologist can use various tests to narrow down the source of your symptoms. These tests include:
Blood tests - to look for signs of a source of infection or inflammation.
Chest x-ray - anatomy of the chest and to show possible signs of heart failure
Electrocardiogram (ECG) - detects abnormal heart rate and rhythm that indicates a damaged heart muscle
Echocardiogram (ultrasound images of the heart) - to help identify structural or functional problems in the heart and adjacent vessels.
Myocardial biopsy (sample of tissue from the heart muscle): In some cases, the doctor may allow you to examine a small piece of muscle tissue from the heart during cardiac catheterization.
Treatment
In many cases, myocarditis improves on its own or with treatment, leading to a full recovery. Treatment for myocarditis focuses on the causes and symptoms of heart failure.
In mild cases, people should stay away from competitive sports for at least three to six months. You will need rest and medicine to help your body fight the infection that causes myocarditis. Although antiviral drugs are available, they have not been shown to be effective in treating most cases of myocarditis.
Some rare viral myocarditis, such as eosinophilic and giant cell myocarditis, may respond to corticosteroids or other actions to suppress the immune system. In some cases caused by chronic diseases like lupus, treatment for the underlying disease is prescribed.
Medicines that help your heart
If myocarditis causes heart failure or arrhythmia, your doctor may hospitalize you and prescribe medications or other treatments. For some abnormal heart rhythms or severe heart failure, you may be given medicine to reduce the risk of blood clots in the heart.
If your heart is weak, your cardiologist may prescribe medicine to help reduce the workload on your heart or help it remove excess fluid:
Angiotensin Converting Enzyme (ACE) Inhibitors. These drugs, such as Enalapril (Vasotec), Captopril (Capoten), Lisinopril (Gestril, Prinivil), and Ramipril (Altace), relax the blood vessels in the heart and help ease blood flow.
Angiotensin II receptor blockers (ARBs). These drugs, such as Losartan (Kozar) and Valsartan (Diovan), relax the blood vessels in your heart and help blood flow more easily.
Beta blockers. Beta-blockers such as metoprolol (lopressor, toprol-XL), bisoprolol, and carvedilol (Coreg) work in many ways to treat heart failure and control arrhythmia.
Urination. These medications, such as furosemide (LASIX), relieve sodium and fluid retention.
Treatment for severe cases
In some severe cases of myocarditis, aggressive treatment may include:
Intravenous (IV) drugs. These improve the heart's pumping performance more quickly.
Ventricular assist equipment. Ventricular assist devices (VADs) are mechanical pumps that help deliver blood from the lower chambers (ventricles) of your heart to the rest of your body. DAVs are used in people whose heart is weakened or whose heart has stopped. This treatment can be used while waiting for your heart to recover or for other treatments, such as a heart transplant.
Intra-aortic balloon pump. Doctors insert a thin tube (catheter) into a blood vessel in the leg and guide it to the heart using X-ray images. Doctors place the balloon attached to the end of the catheter into the body from the heart (aorta) into the main artery. . When the balloon inflates and blooms, it helps increase blood flow and reduces the workload on the heart.
Extracorporeal membrane oxygenation (ECMO). With severe heart failure, this device delivers oxygen to the body. When blood is drawn from the body, it passes through a special membrane in the ECMO machine that removes carbon dioxide and adds oxygen to the blood. The freshly oxygenated blood returns to the body.
The ECMO machine takes over the work of the heart. This treatment can be used while awaiting heart recovery or other treatments, such as a heart transplant.
In very serious cases, cardiologists may consider an emergency heart transplant.
Some people may have chronic, irreversible heart muscle damage that requires lifelong medication, while others may need medication for a few months and then make a full recovery. Either way, your doctor will likely recommend regular follow-up appointments, including tests, to evaluate your condition.
Lifestyle and home remedies
Relaxing and reducing the workload on your heart is an important part of recovery. Your doctor will tell you what kind of physical activity you can do during the months when your heart recovers and when you can resume your normal activities.
If you have a heart attack, it's important to keep salt to a minimum, limit the amount of fluids you drink, at least drink alcohol, and if anything, smoke. Your doctor will tell you how to take your fluid intake, as well as how much salt to include in your diet.
Complications
Acute myocarditis can permanently damage the heart muscle, which can be caused by:
Heart failure. If left untreated, myocarditis can damage the heart muscle and prevent it from pumping blood effectively. In severe cases, heart failure related to myocarditis may require a ventricular assist device or a heart transplant.
Heart attack or stroke. If your heart muscle is injured and cannot pump blood, the blood that has collected in your heart can clot. If a clot clogs one of your arteries, you have a heart attack. If the blood from your heart goes to the artery to the brain before it clots, you have a stroke.
Fast or abnormal heart rhythms (arrhythmia). Damage to the heart muscle can lead to arrhythmia.
Sudden cardiac death. Some serious arrhythmias can cause your heart to stop beating (sudden cardiac arrest). It can be fatal if not treated right away.
Prevention
There is no specific cure for myocarditis. However, following these steps can help prevent infection:
Avoid people with viral or flu illnesses until they recover. If you are sick with viral symptoms, try not to expose others.
Practice good hygiene. Washing your hands daily helps prevent the spread of the disease.
Avoid risky behaviors. To reduce the risk of HIV-related myocardial infection, practice safe sex and avoid the use of illicit drugs.
Reduce exposure. If you spend time in tick-infected areas, wear long-sleeved shirts and long pants to cover your skin as much as possible. Apply insect or tick repellents that contain DEET.
Get your shots. Diseases that cause myocarditis: Stay up-to-date with recommended vaccines, including those that protect against rubella and influenza.
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