MYOCARDITIS

General Information

DEFINITION--Inflammation of the heart muscle (myocardium) that usually occurs as a complication of underlying illness, such as hypersensitive immune reactions, injury, radiation therapy, infection or toxic reactions to drugs.

BODY PARTS INVOLVED--Heart muscle.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

Fatigue. Shortness of breath. Irregular heartbeat. Fever. Other symptoms caused by the underlying disorder. If myocarditis causes congestive heart failure, the following symptoms may also occur:

• Swollen feet and ankles.
• Distended neck veins.
• Rapid heartbeat, even when at rest.
• Breathing difficulty while resting or lying down.

CAUSES

• Viral infections, such as measles, influenza or adenovirus.
• Bacterial infections, such as tetanus, gonorrhea, typhoid fever, tuberculosis or diphtheria.
• Surgery on the heart.
• Rheumatic fever.
• Parasite infections.
• Radiation therapy for cancers in the chest, such as lung or breast cancer.
• Certain medications.

RISK INCREASES WITH

• Exposure to any of the Causes.
• Excess alcohol consumption.

HOW TO PREVENT

• Don't drink more than 1 or 2 alcoholic drinks, if any, a day.
• Keep immunizations current against diphtheria, tetanus, measles, rubella and polio.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies.
• ECG (See Glossary), cardiac catheterization and angiography (See Glossary).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Hospitalization for the underlying disorder (frequently).
• Heart transplantation may be the only effective treatment for some types.

POSSIBLE COMPLICATIONS--

Even with excellent treatment of the underlying disorder, a few patients develop:

• Congestive heart failure.
• Permanent damage to the heart muscle or valves.
• A blood clot inside the heart muscle that can break away and lodge elsewhere in the body. This may be life-threatening.

PROBABLE OUTCOME--Often curable with detection and treatment of the underlying cause.

How To Treat

GENERAL MEASURES--

• Treatment includes medications for infections, rest and careful management of any complications. Compliance with your treatment plan is important for your recovery.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Antibiotics to fight infection, if myocarditis is caused by a bacterial infection.
• Appropriate medications, if myocarditis develops into congestive heart failure. These include: Diuretics to reduce fluid retention. Digitalis to stimulate a stronger heartbeat. Anticoagulants to prevent clot formation. Medications to reduce the heart's workload. Supplemental oxygen if necessary.

ACTIVITY--

• Rest in bed until symptoms disappear. Recovery time varies, depending on the underlying cause. Use a bedside commode for bowel movements while at complete bed rest. This causes less stress than a bedpan.
• After recovery, resume your normal activities gradually.

DIET--No special diet unless recommended by your doctor.

Call Your Doctor If

• You have symptoms of myocarditis.
• The following occurs during treatment: Recurrence of fever or chills. Increased shortness of breath.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.