Inflammation of the heart muscle is a dangerous complication of infections. The most common pathogens of myocarditis are the viruses that also cause a flu-like infection. In this case, the viruses not only spread in the upper respiratory tract, but also reach the heart muscle, the so-called myocardium, via the blood. At least 5% of all infections are transmitted to the heart muscle. The first warning signs can be: chest pain, heart palpitations, tiredness, a general feeling of malaise or shortness of breath.
However, inflammation of the heart muscle is often accompanied by only mild symptoms and the symptoms are difficult to distinguish from those of the cold that causes it.
Other pathogens that heart muscle inflammation are viruses or bacteria that are responsible for intestinal inflammation. In general, however, any pathogen can cause myocarditis. Examples of this are tonsillitis caused by streptococci or tick-borne Lyme disease.
Recently, there have been increasing reports that various medications are also responsible for the development of myocarditis.
Symptoms of Myocarditis
Unfortunately, there are no typical symptoms of myocarditis. The symptoms are as non-specific as those of a flu infection. However, symptoms such as cardiac arrhythmia, chest pain or shortness of breath are particularly suspect. A deterioration in general health and loss of appetite can also indicate myocarditis.
Diagnosis of Myocarditis
During the blood test, particular emphasis is placed on laboratory values that are considered markers of inflammation, such as erythrocyte sedimentation rate, CRP or blood count. Cardiac muscle enzymes such as CK or CK-MB as well as troponin indicate the destruction of the heart muscle. The so-called pro BNP test can detect the onset of heart failure at an early stage.
The ECG often shows an accelerated heart rate and cardiac arrhythmias, which can occur in attacks or permanently.
In addition, changes in the ST segment and the T wave. To clarify the cardiac arrhythmia, a Holter necessary.
Of particular importance for Diagnosis If myocarditis is suspected, the so-called Echocardiography (Ultrasound of the heart). Echocardiography can be used to diagnose reduced pumping performance of the heart at an early stage. Echocardiography can differentiate between a mild and a severe form of myocarditis in the early stages. The pericardium is often also involved in inflammation of the heart muscle. This leads to a build-up of fluid in the pericardium (pericardial effusion). This type of pericarditis can be clearly seen in echocardiography.
If blood count, ECG and echocardiography do not rule out myocarditis, a magnetic resonance imaging (cardio-MRI) scan of the heart may be indicated.
Therapy and Prognosis for Myocarditis
The most important therapeutic measure is physical rest: no heavy physical work, no SportEven if the cough and cold have gone, the pathogens can still spread in the heart muscle and damage the tissue. It is therefore important to avoid sport and heavy physical work until there are no more signs of myocarditis.
Fortunately, inflammation of the heart muscle rarely leads to sudden cardiac death, although undetected myocarditis does repeatedly lead to sudden deaths of apparently healthy young athletes.
If myocarditis is diagnosed early, it usually does not lead to chronic damage to the heart after appropriate therapeutic measures have been taken. Possible consequences include persistent cardiac arrhythmias, heart failure or dilated cardiomyopathy, which results in persistent severe enlargement of the heart.
Summary
About 5% of all infections result in myocarditis.
Laboratory tests, ECG and echocardiography are important components in diagnosing myocarditis. Myocarditis discovered early can usually be completely cured with appropriate measures.
