Inflammation of the heart muscles is a severe health issue. Although it often goes unnoticed, it is usually diagnosed during autopsies of people with unexplained causes of death. The complaints are often quite unspecific. Nobody knows exactly how common myocarditis is - the number of unrecognized cases is very high. However, on the autopsy table, in about 1% of adults, their sudden death is attributed to myocarditis, and in children as young as 16-21%. Not funny at all and a serious health issue for the society.

Causes of heart inflammation (Myocarditis)

There are many causes of myocarditis according to science news. It can be caused by an infection with various pathogens - viruses, bacteria, protozoa, parasites, and fungi - or can be the result of an excessive defense reaction (autoimmune reaction). It can be caused by chemical, potentially toxic substances (e.g., medicines such as certain antibiotics or chemo therapeutic agents) or physical stimuli (e.g., radiation). Myocarditis can also occur after a heart attack and heart surgery.

In our latitudes, by far the most common cause is a virus infection, usually with the Coxsackie virus type B. The inflammation that follows the disease and the corresponding immune reaction destroys the heart muscle cells, the surrounding connective tissue and the small vessels inside. Sometimes the inflammation also spreads to the pericardium - this is called perimyocarditis.

Symptoms of myocarditis

The nature of myocarditis symptoms is quite unspecific - which makes a diagnosis so tricky. The patients often report a previous infection of the upper respiratory tract with similar complaints. The heart muscle inflammation itself can manifest itself on the one hand through general symptoms: Aching and feeling of weakness, fatigue, fever, restlessness, but also joint and muscle pain - complaints that are often attributed to respiratory tract infections.

There are not always heart-specific complaints caused by cardiac arrhythmias, pericardial irritation and impaired cardiac performance (insufficiency): accelerated pulse (even without physical exertion), palpitations or stumbles, shortness of breath during exercise, a feeling of pressure or chest pain, dizziness and fainting spells. The most common of these complaints are fatigue and shortness of breath, followed by palpitations and chest pain.

Diagnosis and treatment

If you do not feel on the dam again after an infection or have some of the described complaints, you should consult a doctor. If the symptoms you describe support this suspicious diagnosis, he will first physically examine you (especially heart and lungs) and measure your blood pressure and pulse.

Diagnosis of myocarditis

Essential examinations that complete the picture are electrocardiogram (ECG) and echocardiography (heart ultrasound) technology. Cardiac arrhythmias and other changes, which are not specific for myocarditis, but also occur in other heart diseases, are particularly evident in ECG.

Echocardiography can be used to detect the expansion of the heart cavities, disorders of coordination in heart movement and to measure the performance of the heart; in the case of inflammation of the pericardium, a typical accumulation of fluid between the pericardium and myocardium can be detected, the so-called pericardial effusion. However, the ultrasound findings only provide puzzle pieces but are not specific.

Blood, stool or throat swab tests may detect signs of inflammation, viruses or defense cells (antibodies) formed by the body. A further investigation is a scintigraphy, in which inflamed cells are less active and therefore store less of an injected substance. Magnetic resonance imaging (MRI) is an excellent way to visualize the centers of inflammation and scarring of muscle tissue - the examination is expensive but provides quite specific results.

If, after these examinations, the suspected diagnosis is still not specific, a tissue sample is taken from the heart muscle (myocardial biopsy) and fluid from the pericardium. Which diagnostic measures are made depends on the condition of the affected person, his age, the accompanying diseases and the possible consequences of the therapy.

Treatment of myocarditis

As little as there are specific symptoms, as little myocarditis can be treated individually. Don't fall for pseudoscience treatments. Instead, the focus is on general measures: Bed rest, later physical rest (no sport, no hard physical work) until the findings have normalized. If necessary, the underlying disease or infection is treated.

If myocarditis has affected heart function, these symptoms are treated with medication for heart failure and cardiac arrhythmia. In severe cases, treatment methods ranging from particular drugs to heart transplants are used - but only in specialized clinics.

Inflammation and Heart Disease Explained