DESCRIPTIONMyocarditis is inflammation of the heart muscle (myocardium) that usually occurs as a complication of underlying illness, hypersensitive immune reactions, injury, or radiation therapy. All the chambers of the heart are involved.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications.
Hospitalization for the underlying disorder (frequently).
SIGNS & SYMPTOMSFatigue.
Shortness of breath.
Other symptoms caused by the underlying disorder.
If myocarditis causes congestive heart failure, the following symptoms will also occur:
Swollen feet and ankles.
Distended neck veins.
Rapid heartbeat, even when at rest.
Breathing difficulty, even when the child is sleeping or at rest.
CAUSESViral infections, such as measles, influenza, or adenovirus.
Bacterial infections, such as tetanus, gonorrhea, typhoid fever, tuberculosis, or diphtheria.
Surgery on the heart.
RISK FACTORSExcess alcohol consumption.
Geographic location. Parasite infections are common in underdeveloped countries.
PREVENTING COMPLICATIONS OR RECURRENCE
Urge your child not to drink more than 1 or 2 alcoholic drinks--if any--a day.
Keep your child's immunizations current against diphtheria, tetanus, measles, German measles, and polio. See Appendix 1.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood studies.
EKG (See Glossary).
Other studies appropriate for the underlying disorder.
POSSIBLE COMPLICATIONSEven with excellent treatment of the underlying disorder, a few children 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.
Usually curable with detection and treatment of the underlying cause.
HOME CAREYour child must have complete nursing care, including help with bathing and eating.
MEDICATIONAntibiotics to fight infection, if your child's myocarditis is caused by a bacterial infection.
Cortisone drugs to reduce inflammation.
Appropriate medications, if the myocarditis develops into congestive heart failure. These include:
-- Diuretics to reduce fluid retention.
-- Digitalis to stimulate a stronger heartbeat.
-- Anticoagulants to prevent clot formation.
See Medications section for information regarding medicines your doctor may prescribe.
Your doctor may prescribe:
ACTIVITYYour child should rest in bed until symptoms disappear. Recovery time varies, depending on the underlying cause. Your child may read or watch TV.
Your child should use a bedside commode for bowel movements while at complete bed rest. This causes less stress than a bedpan.
After recovery, the child can resume normal activities gradually.
DIET & FLUIDS
Your child should eat a low-salt diet (See Appendix 29).
OK TO GO TO SCHOOL?When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of myocarditis.
The following occurs during treatment:
-- Recurrence of fever of chills.
-- Increased shortness of breath.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.