(Long term) ECG
The ECG (abbreviation for: electrocardiogram) is also used in the diagnosis of heart muscle inflammation. The electrical actions of the heart are measured, which provide information about possible rhythm disturbances or diseases in the electrical conduction system of the heart. In the case of myocarditis, the rhythm of the heart is often too fast; in addition, additional heart beats outside the rhythm, so-called extrasystoles, can occur. These phenomena are often also felt by the patient. Characteristic findings in the ECG can be
- Extrasystoles
- Rhythm disturbances
- ST-Segment changes
- Excitation conduction disorders
- Block formations (AV block)
Laboratory values in blood
Another important support in the diagnosis of myocarditis is the examination of the blood. For this, blood must be taken from the patient’s vein and then examined in a laboratory. The increase of some inflammation values in the blood is possible with myocarditis, but not always the case.Frequently examined inflammation parameters are the CRP (C-reactive protein), the leukocyte count and the blood sedimentation rate (in short: BSG).
Furthermore, there are laboratory values that indicate a pathological process in the heart muscle, which can also be elevated in myocardial inflammation. These are the CK-MB and the troponin T/I. Since myocarditis very often develops after a viral or bacterial infection, the aim is to detect frequent pathogens in the blood. Characteristic findings in the laboratory are:
- Increase in cardiac enzymes (CK, CK-MB, Troponin T)
- Increase of NT-proBNP
- Possible virus detection in blood
- If necessary, detection of autoantibodies against structures in the heart muscle tissue as part of an autoimmune reaction
Imaging of a heart muscle inflammation
- X-ray thorax (detection of a disseminated heart as well as a backflow of blood into the lungs)
- Echocardiography (ultrasound of the heart)
- MRI
The ultrasound examination of the heart is usually performed by a cardiologist. The advantage of ultrasound is that the physician can make an imaging diagnosis without exposing the patient to radiation. Ultrasound may reveal a thickening of the heart wall in the case of myocardial inflammation.
The ultrasound examination can assess the pumping function of the heart, which is helpful in assessing the severity of the disease. This form of examination is also used to assess the course of the disease. In the MRI (abbreviation for: magnetic resonance imaging) of the heart, characteristic changes are visible in the case of an existing heart muscle inflammation, which is why this imaging is useful for diagnosis.
MRI works with strong magnetic fields that excite the hydrogen atoms in the molecules of the body. Due to the characteristic behavior of the individual hydrogen atoms in the different tissues, this examination enables the computer to produce an image of the body. The patient is also not exposed to radiation during the MRI examination.
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