Myocarditis
Myocarditis, also known as inflammatory cardiomyopathy, is an acquired cardiomyopathy due to inflammation of the heart muscle. Symptoms can include shortness of breath, chest pain, decreased ability to exercise, and an irregular heartbeat. The duration of problems can vary from hours to months. Complications may include heart failure due to dilated cardiomyopathy or cardiac arrest.
| Myocarditis | |
|---|---|
| Other names | Inflammatory cardiomyopathy (infectious) |
| A microscope image of myocarditis at autopsy in a person with acute onset of heart failure | |
| Specialty | Infectious disease, cardiology |
| Symptoms | Shortness of breath, chest pain, decreased ability to exercise, irregular heartbeat |
| Complications | Heart failure due to dilated cardiomyopathy, cardiac arrest |
| Duration | Hours to months |
| Causes | Usually viral infection, also bacterial infections, certain medications, autoimmune disorders |
| Diagnostic method | Electrocardiogram, blood troponin, heart MRI, heart biopsy |
| Treatment | Medications, implantable cardiac defibrillator, heart transplant |
| Medication | ACE inhibitors, beta blockers, diuretics, corticosteroids, intravenous immunoglobulin |
| Prognosis | Variable |
| Frequency | 2.5 million with cardiomyopathy (2015) |
| Deaths | 354,000 with cardiomyopathy (2015) |
Myocarditis is most often due to a viral infection. Other causes include bacterial infections, certain medications, toxins and autoimmune disorders. A diagnosis may be supported by an electrocardiogram (ECG), increased troponin, heart MRI, and occasionally a heart biopsy. An ultrasound of the heart is important to rule out other potential causes such as heart valve problems.
Treatment depends on both the severity and the cause. Medications such as ACE inhibitors, beta blockers, and diuretics are often used. A period of no exercise is typically recommended during recovery. Corticosteroids or intravenous immunoglobulin (IVIG) may be useful in certain cases. In severe cases an implantable cardiac defibrillator or heart transplant may be recommended.
In 2013, about 1.5 million cases of acute myocarditis occurred. While people of all ages are affected, the young are most often affected. It is slightly more common in males than females. Most cases are mild. In 2015 cardiomyopathy, including myocarditis, resulted in 354,000 deaths up from 294,000 in 1990. The initial descriptions of the condition are from the mid-1800s.