Heart Muscle Inflammation (Myocarditis): Diagnosis and Treatment

If you do not feel back on your feet for a longer period of time after an infection or if you have some of the symptoms described, you should consult a doctor. If the symptoms you describe support a suspected diagnosis of myocarditis, he or she will first examine you physically (especially your heart and lungs) and take your blood pressure and pulse. You can find out what other tests are done and how myocarditis is treated here.

Diagnosis of myocarditis

Important examinations for diagnosing myocarditis, in addition to examining the heart and lungs or taking your pulse and blood pressure, include an electrocardiogram (ECG) and echocardiography (heart ultrasound):

  • In particular, the ECG shows cardiac arrhythmias and other changes, although these are not specific to myocarditis, but also occur in other heart diseases.
  • Echocardiography can detect dilatation of the heart cavities as well as disturbances in coordination in cardiac motion and measure the performance of the heart; in the case of inflammation of the pericardium, an accumulation of fluid between the pericardium and the heart muscle (myocardium), which is typical for this condition, can be detected, the so-called pericardial effusion. However, ultrasound findings also provide only pieces of the puzzle, but are not specific.
  • Examinations of blood, stool or a throat swab may detect signs of inflammation, viruses or defense cells (antibodies) formed by the body against it.
  • Another examination is scintigraphy, in which inflamed cells are less active and therefore store less of a substance injected.
  • Magnetic resonance imaging (cardio-MRI) is a good way to visualize inflammation and scarring of muscle tissue – the examination is expensive, but provides fairly specific results.
  • If after these examinations the suspected diagnosis is still not confirmed, a tissue sample is taken from the heart muscle (myocardial biopsy) and / or fluid from the pericardium.

Which diagnostic measures are taken depends on the condition of the affected person, his age, concomitant diseases and the possible consequences for therapy.

Treatment of myocarditis

Medical experts estimate that in at least 90 percent of cases, myocarditis goes unnoticed and heals on its own. But in the remaining cases, life-threatening complications can sometimes occur, which is why proper therapy is critical.

As few as there are specific symptoms, myocarditis cannot be treated specifically. Instead, the focus is on general measures: Bed rest, later physical rest (no sports, no heavy physical work) until the findings have normalized. If necessary, the underlying disease or infection is treated.

If the myocarditis has affected the heart function, these symptoms are treated with drugs against cardiac insufficiency and cardiac arrhythmias. In severe progressions, treatment methods with special medications up to and including heart transplantation are performed – but only in clinics that specialize in this.