Do you sometimes feel just tired, a little short of breath? Or do you feel like your chest hurts a little, or your heart beats faster than usual? These can be normal things, but sometimes these symptoms can also be caused by a heart problem. Today we are going to talk about an inflammation, that is, swelling, of the heart muscle. In medical terms, we call this myocarditis.
What is myocarditis?
Simply put, myocarditis is an inflammation or swelling of your heart muscle, the myocardium. Think of it like when we get a cut on our skin, the area becomes swollen, red, and painful. When that happens in the heart muscle, we call it myocarditis.
When the heart muscle becomes inflamed in this way, the heart's function can become impaired. This makes it difficult for the heart to pump blood. This is a rare condition, meaning it is very rare. Some people may develop it suddenly, while others may develop symptoms gradually over time.
Myocarditis is different from other inflammatory conditions of the heart. For example:
- Pericarditis is an inflammation of the sac that surrounds the heart.
- Endocarditis is an infection or inflammation of the heart valves.
There are also several rare types of myocarditis:
- Lymphocytic myocarditis
- Giant cell myocarditis
- Fulminant myocarditis
- Eosinophilic myocarditis
How does it feel to have myocarditis?
Many people with myocarditis may experience fatigue, shortness of breath, chest pain, or palpitations. Some people may develop these symptoms gradually over time. Others may have a sudden, severe attack. When myocarditis becomes more severe, symptoms of heart failure may develop. This is when the heart stops working properly.
What are the symptoms of Myocarditis?
You may not have any symptoms at all. Or you may have one or more symptoms. The severity of these symptoms can vary from person to person. Check to see if you have any of these symptoms:
- Difficulty breathing (especially when exercising or lying down)
- Severe fatigue, exhaustion
- Fever (if associated with a viral infection)
- Chest pain (which may feel sharp, stabbing, or like a pressure in the chest)
- Palpitations or irregular heartbeat
- Stomach pain
- Vertigo (feeling like you're spinning)
- Abnormal heart rhythm
- Fainting
- Appetite
- Lifeless body
- Swelling of the legs or ankles
- Inability to exercise
How common is this condition?
Researchers estimate that about 1.5 million cases of myocarditis are reported worldwide each year. This means that this condition may affect between 10 and 20 out of every 100,000 people . So, while it may seem like it's not very common, it's important to remember that anyone can develop it.
Why does myocarditis occur?
In most cases, it is difficult to find a specific cause for myocarditis. However, the most common cause is a viral infection. Some of the viruses that cause myocarditis are:
- Flu virus
- Herpes virus six
- Adenovirus
- Coxsackie virus
- Parvovirus B19
- SARS-CoV-2 (COVID-19) virus
What are the other reasons?
Myocarditis can be caused by other reasons besides viruses:
- Bacterial infections
- Fungal infections (this is very rare)
- Chagas disease
- Rheumatic fever
- Autoimmune diseases - For example, rheumatoid arthritis or lupus. These are diseases in which the body's immune system attacks its own cells.
- Exposure to certain things - for example, radiation or heavy metals.
Could it be due to some medications?
Yes, myocarditis can occur as a side effect of some medications. Some of these medications include:
- Some medications for heart disease
- Medications for depression (Antidepressants)
- Medicines for seizures
- Antibiotics
- Some medications for weight loss
- Diuretics (medicines that remove water from the body)
- Benzodiazepines (a type of medication that causes drowsiness and reduces anxiety)
- Some medications for mental health problems
Is there a link between myocarditis and the Covid-19 vaccine?
Yes, this is also important. Very rarely , cases of myocarditis have been reported in people who received the Pfizer-BioNTech® or Moderna® COVID-19 vaccine, especially among young people. Symptoms can occur within the first week of receiving the vaccine.
But remember, this is a very rare occurrence. Many people who have developed myocarditis from this vaccine have recovered quickly after treatment and returned to their normal lives. However, if you have developed myocarditis, you should definitely consult a cardiologist before starting exercise again.
The CDC (Centers for Disease Control and Prevention) says that the risk of getting COVID-19 far outweighs the risk of this rare side effect, so they still recommend getting the vaccine.
Who is at higher risk of developing myocarditis?
Some risk factors we cannot change. You are more likely to develop myocarditis if you have:
- If you are young. But, this can happen to anyone of any age.
- If you are a man. But women can develop it too.
- Your body's response to inflammation is poor. Myocarditis is not a hereditary disease. However, your genes can affect how your body responds to inflammation and your risk of developing myocarditis.
- If you drink more alcohol than your doctor has prescribed.
Some medical treatments can also increase the risk of myocarditis. These include:
- Dialysis (dialysis - blood filtration when kidneys fail)
- Implanted heart devices
- Radiation therapy
- Some treatments for heart disease
- Having a central venous line inserted into a vein
The risk of developing myocarditis is higher if you have these conditions:
- Diabetes (Diabetes Mellitus)
- HIV/AIDS
- Skin wounds or infections
- Cancer treated with certain medications
- Eating disorders
- End-stage kidney disease
- An accident to the chest
What other complications can occur due to myocarditis?
Some people may develop other health problems due to myocarditis. Some of them are:
- Cardiomyopathy - Weakening or enlargement of the heart muscle.
- Lung problems
- Arrhythmia - irregular heartbeat
- Loss of consciousness
- Heart failure - heart failure
- Cardiogenic shock - a life-threatening condition caused by the heart's inability to pump enough blood
- Sudden cardiac death
How does a doctor diagnose myocarditis?
Your doctor will use these things to determine if you have myocarditis:
- Physical exam: The doctor will do things like listen to your heart and check your pulse.
- Medical history: You will be asked about any previous illnesses you have had, whether anyone in your family has heart disease, and what medications you are taking.
- Special Tests: Various tests can be done to confirm the disease.
What tests are being done?
To determine whether it is myocarditis or some other problem, the doctor may order tests such as:
- MRI (Magnetic Resonance Imaging) scan: Can obtain detailed images of the heart.
- Heart biopsy: Taking a small piece of heart tissue and examining it under a microscope is the best way to confirm the disease.
- PET (Positron Emission Tomography) scan: Helps to find areas of inflammation in the heart.
- Chest X-ray: To check the size of the heart and whether there is any fluid accumulation in the lungs.
- Cardiac catheterization: To measure the pressure in the heart chambers and look for blockages in the coronary arteries.
- ECG/EKG (Electrocardiogram): Records the electrical activity of the heart. Can detect irregularities in the heartbeat.
- Echocardiogram: An ultrasound scan of the heart. It can look at things like the size, shape, and how well the heart pumps blood.
- Blood tests: Check for things like levels of enzymes that accumulate in the blood when the heart muscle is damaged, and inflammatory markers.
Can myocarditis be cured? What are the treatments?
If you have a mild case of myocarditis, it may resolve on its own. Otherwise, your doctor may prescribe medication.
Can it be cured with medicine?
Yes, the doctor may prescribe the following medications to treat myocarditis:
- Heart failure medications: These help improve heart function and reduce symptoms. For example, ACE inhibitors, beta blockers, diuretics.
- Corticosteroids: These are a type of medication that reduces inflammation.
- Intravenous (IV) immunoglobulin (IVIG): This is also a treatment that alters the function of the immune system and reduces inflammation.
Will surgery be necessary?
If myocarditis is causing heart failure or an abnormal heart rhythm, and the condition is severe, surgery to implant a device such as this may be necessary:
- LVAD (Left Ventricular Assist Device): A device that helps the left ventricle of the heart pump blood.
- Pacemaker: A device that is implanted to correct an irregular heartbeat.
- Heart transplant (Donor heart): As a last resort, a healthy heart from someone else may need to be transplanted.
What can we do to reduce the risk of developing myocarditis?
Unfortunately, many of the causes of myocarditis (especially viral infections) are difficult to prevent. The best thing to do is to wash your hands frequently and stay healthy. This will help you avoid infections that can cause myocarditis.
It's also important to get your flu shot on time. Limiting alcohol consumption and not using illegal drugs are also risk factors you can control.
What is the future if I develop myocarditis?
Your prognosis with myocarditis depends on how severe your symptoms are and how much inflammation there is in your heart. Many people live for years without any problems after treatment. Others may need to continue taking medication. Also, you have a small risk of developing myocarditis again.
For some people, myocarditis can lead to serious complications, such as dilated cardiomyopathy. This is when the heart becomes enlarged and weak. Over time, this can lead to heart failure, which may require a heart transplant. Myocarditis is also said to be responsible for about 20% of sudden deaths in young people. Although most people recover, it can be a life-threatening condition.
Typically, between 50% and 80% of people with viral myocarditis live five years or more after diagnosis. Many people, especially young people, make a full recovery and lead healthy, active lives.
How do we take care of myocarditis?
If you have myocarditis once, it can happen again years later. So, be sure to tell your doctor if you have any symptoms again. To stay healthy, do these things:
- Be sure to go to the doctor on the scheduled dates.
- Take the prescribed medication exactly and on time.
- Do not exercise until your doctor tells you to.
- Reduce salt in your diet.
- Stop using tobacco products.
- Do not drink alcohol.
Also, the doctor may need to repeat some of the tests used to make the diagnosis (e.g., echocardiogram, MRI scan).
Important questions to ask your doctor
When you go to see the doctor, you can ask questions like these:
- Why did I develop myocarditis?
- Will I need treatment for myocarditis?
- What can I do to stay healthy?
Finally, things to remember
Myocarditis is a rare condition that can weaken your heart muscle. Unfortunately, many of the things that cause it are difficult to prevent. While some people may have severe symptoms, many people live for years without any problems after treatment.
The best thing you can do is to keep seeing your doctor on time, take your prescribed medication exactly as prescribed, and let your doctor know if your symptoms return. Don't panic, but be aware of this.
` myocarditis, inflammation of the heart, heart muscle, chest pain, shortness of breath, heart disease, viral infections
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