Can you get heart muscle inflammation from stress?

Myocarditis is caused by pathogens such as viruses and bacteria. Therefore stress as the sole cause of the disease is out of the question. However, stress can damage the heart in other ways, making the heart muscles more susceptible to myocarditis.

Stress is particularly damaging if it is permanent. For example, chronic stress can promote a heart attack, it increases blood pressure and also damages the blood vessels. These factors have a negative effect on the entire cardiovascular system and can thus make the heart more susceptible to disease in the long term.

Epidemiology

Viruses, which can potentially cause myocarditis, cause 1% of myocarditis. The number of undetected cases is very high, as there are also many clinically unremarkable myocarditites that cause sudden cardiac death in young people and are not discovered until the autopsy. At 50%, viruses are the most common cause of heart muscle inflammation.

Myocarditis caused by viruses are in some cases caused by a so-called cross antigenicity. The cause here is an overreaction of the immune system between the viral structures and the heart muscle cells. In these immune-induced heart muscle inflammations, so-called antimyolemmal antibodies (AMLA) of the IgM type, antisarcolemmal antibodies (ASA) of the IgM type, as well as IgM antibodies and complement factors C3 are found in the biopsy of the heart muscle in 70-80% of cases in an acute flare. All these factors indicate that the immune system is particularly active, although infection may not affect the patient at this time.

Measurable symptoms

The ECG (electrocardiogram) usually shows cardiac arrhythmias up to dangerous ventricular tachycardia. Findings such as the so-called S-T segment elevations can resemble those of a heart attack. In severe, rapidly developing (fulminant) disease processes, an enlarged heart can be detected radiologically.

A pericardial effusion (pericardial effusion) can be detected in 20% of cases by echocardiography (heart ultrasound). Our blood pressure is composed of the systolic (“first”, “higher”) and diastolic (“second”, “lower”) values. The systolic value describes the pressure in the major arteries while the heart pumps blood into the circulation.

The diastolic value, on the other hand, describes the pressure during the filling phase of the heart. Ideally, blood pressure is about 120/80mmHg, depending on age and constitution. In the event of myocarditis, the blood pressure may change, but this is not necessarily the case.

A lowering of blood pressure (hypotension) can often be observed, especially when viruses are the cause of the heart muscle inflammation. Systolic values below 100mm Hg are not uncommon. Nevertheless, a lowered blood pressure alone is no proof of the disease.

If, however, an increased heart rate at rest (>100 beats/minute) is added to this, the symptoms can be groundbreaking. Fever is defined as an increase in body temperature above about 37 degrees Celsius. The standard values vary individually and depend on the method of measurement.

In addition, daytime fluctuations can be observed. It is not uncommon for those affected to report heart muscle inflammation from previous fever.It usually occurs in the context of viral infections and is accompanied by flu-like symptoms such as aching limbs or feelings of weakness. The level of the fever can vary and is not linked to the severity of the heart muscle inflammation. In principle, the disease does not necessarily have to be accompanied by fever. In severe, untreated cases, the inflammation can spread to the whole body and cause a so-called sepsis (blood poisoning) with high fever.