Heart muscle inflammation or myocarditis is a disease of the heart. In this case, this inflammation of the heart muscle, can be both chronic and acute. Without treatment, myocarditis can have serious physical consequences and should therefore be treated by a doctor without fail.
What is heart muscle inflammation?
In myocarditis, also called myocarditis in the technical term, there is an inflammation of the heart muscle or the pericardium. If the pericardium is also affected, however, physicians speak of perimyocarditis. However, it is often difficult to separate the two diseases when making a diagnosis. The inflammation of the heart muscle leads to a disturbance of the heart’s ability to contract. This results in a drop in physical performance or even heart failure. This inflammation is also known, in some cases, to cause sudden cardiac death.
Causes
Myocarditis is most commonly caused by viruses in Western countries. The best known here is infection with the Coxsackie B virus. This often occurs as a cause of colds and meningitis. An unhealed flu-like infection or gastrointestinal flu can also lead to myocarditis. Especially if the illness is not properly cured and the affected person engages in physical activity too soon, such as endurance sports. Myocarditis can also be caused by a bacterial disease. Here, the most common are diphtheria, scarlet fever and Lyme disease. This is a disease transmitted by tick bite. In rare cases, the heart muscle can also become inflamed after infection with fungi, parasites or single-celled organisms, such as toxoplasmosis. Heart muscle inflammation due to autoimmune disease, radiation therapy, or the use of medications or drugs is less common but entirely possible.
Symptoms, complaints, and signs
Although myocarditis is often a serious condition, it is not as easy to diagnose because in many cases there are no symptoms or only nonspecific symptoms. These non-specific symptoms can also indicate other diseases. For example, many sufferers complain of general poor performance and fatigue. However, when fatigue increases and shortness of breath occurs with even the slightest exertion, this is considered a serious warning sign of possible myocarditis. These symptoms are often joined by loss of appetite, weight loss, headaches and aching limbs. In some sufferers, direct symptoms of the heart such as palpitations, tightness in the chest (angina pectoris) or even heart palpitations become more frequent. Cardiac arrhythmias such as palpitations or uncoordinated heartbeats often intensify. Increasingly, physical performance is also reduced. Even young people then have increasing difficulties in climbing stairs as well as in all other activities. In severe cases, heart failure results, characterized by water retention in the body, severe shortness of breath and visible congestion of the neck veins. However, the severe cases of myocarditis are rare. Sometimes only mild or no symptoms occur. In other cases, however, acute myocarditis occurs even after a banal flu-like infection and can develop very quickly and lead to severe heart failure within a short time. Sometimes saving the life of the affected patient is only possible by heart transplantation.
Disease progression
The course of myocarditis, or inflammation of the heart muscle, can vary widely. There are problem-poor courses of the heart muscle inflammation with only very weak symptoms, but also severe cases. These can even be fatal. At the beginning, the affected person first notices a general weakness, which is also noticeable during daily activities. This may be accompanied by rapid fatigue and weight loss. Pain in the limbs also occasionally occurs as a symptom of myocarditis. Furthermore, so-called heart stuttering, palpitations or chest pain may occur. Depending on the severity of the disease, even simple physical activities can lead to shortness of breath or even shortness of breath. If the heart muscle inflammation has already limited the function of the heart, water accumulations form in the legs or lungs. A chronic course is also possible.In this, the heart muscle enlarges but loses its ability to contract.
Complications
Myocarditis represents a very serious disease that, in the worst case, can lead to the death of the patient. In this case, the inflammation reduces life expectancy if it is not treated promptly. Patients suffer from severe discomfort of the heart. As a rule, there is pain in the area of the heart and the heart beats faster than usual. Likewise, the affected person feels weak and is no longer able to bear weight in the usual way. Even ordinary and simple activities may seem strenuous to the patient. There is a loss of weight and further aching limbs. In the further course of the myocarditis, shortness of breath occurs, which in most patients also leads directly to a panic attack. The patient’s quality of life is extremely limited by the heart muscle inflammation. Without treatment, spontaneous cardiac death may also occur. The patient’s general condition deteriorates and it is not uncommon for concentration disorders or impaired thinking to occur. Myocarditis can be treated with the help of antibiotics, and no particular complications occur. However, it cannot be predicted whether the heart will be irreversibly damaged by myocarditis and whether this may reduce the patient’s life expectancy.
When should you see a doctor?
Because the symptoms of myocarditis are quite nonspecific, diagnosis is difficult. Myocarditis can go unnoticed for a long time, but that does not mean it is harmless. Heart failure, shortness of breath and similar symptoms should be investigated as soon as possible. One of the leading symptoms, febrile infection, is not yet an urgent problem. However, if a heart condition of any form occurs in conjunction with it (weakness despite rest, breathing problems, palpitations, etc.), myocarditis should be suspected. A doctor should be consulted urgently. The first point of contact is the family doctor, who may then refer the patient to a cardiologist. In particular, people who already have heart failure should see a doctor quickly if they experience any changes in their sensation. The same applies to people who do excessive sport. This can be fatal in combination with myocarditis. A quick trip to the doctor and prompt treatment are in any case in the interest of the person affected. Otherwise, an infection can be carried over or spread. Consequential damage to the heart turns out to be worse the longer the myocarditis remains untreated.
Treatment and therapy
Treatment of myocarditis is usually with medication. If the infection is due to bacteria, it is treated by using antibiotics. If the heart muscle inflammation was caused by viruses, these cannot be treated by medication. In these cases, only the accompanying symptoms are treated. For this purpose, painkillers are administered and possible cardiac arrhythmias are treated by the administration of special drugs. If the heart muscle inflammation has already led to cardiac insufficiency, this is combated with a mixture of diuretic drugs, ACE inhibitors and beta blockers. If there is a large effusion, it is punctured, which means the fluid is suctioned out. If an autoimmune disease is the cause of the myocarditis, it is also treated by administering cortisone. This is to suppress the body’s own defenses. If the inflammation has already led to severe and permanent damage to the heart, the last alternative is heart transplantation. In order to prevent cardiomyocystitis, special care should be taken in the presence of fever. Even with a simple cold, no sports should be done.
Outlook and prognosis
If the patient adheres to the doctor’s instructions, he or she has a good prognosis for myocarditis. With consistent sparing, a healthy lifestyle and avoidance of stress, most sufferers experience a good course of disease and recovery. Myocarditis heals completely and usually without further sequelae. Overexertion should be avoided during the healing process, otherwise complications and a life-threatening condition may result. In about 15% of those with the disease, a chronic course of myocarditis develops.The functional activity of the heart is permanently impaired and its resilience reduced. This has an impact on the patient’s health and prognosis. A change in daily routines is necessary to prevent a deterioration in cardiac function. In many patients, professional and sporting activities have to be restructured and restricted. The patient’s general performance decreases and susceptibility to disease increases. Many patients report shortness of breath and receive lifelong medication. If severe cardiac arrhythmias develop, myocarditis can lead to a fatal outcome. Sudden cardiac death is the result of the irregularities. Basically, patients with heart muscle inflammation must undergo regular check-ups throughout their lives. Cardiac activity is checked so that immediate action can be taken if any irregularities occur.
Follow-up
With the right aftercare, most heart muscle inflammations heal without problems and allow the affected person to live a symptom-free life. Of course, the patient must contribute to this himself. In addition to regular check-ups with the treating physician and strict adherence to the medication regimen, the patient must also observe a three- to six-month grace period. During this period, sports or other strenuous activities are completely prohibited. The cause of myocarditis often lies in infections that have been carried over, during which the affected person has not taken it easy. Even after complete recovery, patients must maintain absolute bed rest in the event of future colds or gastrointestinal infections. This applies not only to high fevers, but also to milder symptoms such as a cold or cough. This is the only way to effectively prevent the heart from being overloaded and the infection from spreading to the heart muscle. Since both a fatty diet and smoking are among the typical risk factors for heart disease, a change in diet and renunciation of smoking are essential. If the patient tends to be overweight, a reduction in weight will help to relieve the cardiovascular system. Everyday life should be reorganized in such a way that stress is avoided. Yoga, meditation or hobbies can be helpful as compensation. Under certain circumstances, psychotherapy can help to better deal with the remaining stress, to find the perfect balance and to relieve the body.
What you can do yourself
Myocarditis (inflammation of the heart muscle) is a very serious disease that must not be treated by oneself under any circumstances, otherwise serious complications may arise. Whether and what the patient can do to cure it himself depends on the cause of the myocarditis. If the disease is due to an infection with bacteria or viruses, which is often the case, then the patient can speed up his recovery by strengthening his body’s own defenses. A predominantly plant-based diet rich in vitamins and fiber is helpful. Meat and sausages, convenience foods, sweets, white flour products and stimulants such as alcohol and cigarettes, on the other hand, are counterproductive. In naturopathy, red coneflower (Echinacea purpurea) is used to strengthen the immune system. However, such over-the-counter medications should never be taken in the case of myocarditis without consulting the attending physician. Regardless of the cause of myocarditis, physical rest is always required. However, it is essential to follow the doctor’s instructions on this point. The same applies to sporting activities, even if these, such as regular walks, are fundamentally beneficial to health. These activities also usually have to be abandoned during myocarditis. Over-exertion during convalescence can lead to a relapse associated with permanent damage to the heart. It is therefore essential for the patient to take the necessary amount of rest.