How is myocarditis diagnosed?
Your doctor will talk with you and perform a complete physical
examination. In particular, he will listen to your chest with
a stethoscope to detect unusual heart sounds. He will probably
order chest x-rays, electrocardiographic (ECGs) and echocardiographic
tests. He may order nuclear testing and imaging (computed Tomography
or Magnetic Resonance) scans. Finally, he may order a biopsy of
your heart muscle. The biopsy is a procedure during which a small
tube (catheter) is inserted into a vein in your neck or leg and
then threaded into your heart. A scissor-like instrument, which
is inserted through the catheter, snips tiny pieces of the myocardium,
which are then studied.
A positive biopsy is the only sure way to know if you have myocarditis,
However, since the biopsy can only test a small area of the heart,
you may still have myocarditis even if the biopsy is negative.
How is myocarditis treated?
Myocarditis is usually treated by a three-pronged approach. First,
therapy will be given for the underlying illness. Second, measures
will be taken to attempt to decrease the workload of the heart.
Finally, your physicians will control the complications of the
Your doctor may recommend modified bed or chair rest and sodium
and exercise restriction. Reduction of physical activity and exercise
reduces the work of the heart. It reduces residual damage and
You may be given medications. Depending on your condition, your
doctor may prescribe one or more of the following: Digoxin, diuretics,
ACE inhibitors, beta blockers and anticoagulants. If you have
a severe case of myocarditis, you may receive steroids and immunosuppressants
which suppress inflammation.
Your condition may require more extensive monitoring and treatment
in the hospital, This treatment may include the insertion of a
temporary assist device such as an intraaortic balloon pump. The
balloon pump is inserted into your aorta above the heart. It takes
over some of the heart's pumping function. In rare cases, a heart
transplant is required.
If you have developed a dangerous arrhythmia due to the myocarditis,
you may be hospitalized in order to receive frequent monitoring.
What are the consequences or complications of myocarditis?
Most cases of myocarditis clear up by themselves without complications.
Some people develop chronic weakness of the heart and heart failure.
The latter is a rare occurrence.
Myocarditis can cause acute pericarditis (inflammation of the
sac surrounding the heart), permanent heart muscle and heart valve
problems, blood clots, stroke, and arrhythmias. Some arrhythmias
may be fatal if untreated.
On rare occasions, untreated myocarditis can lead to death. Again,
this depends upon the underlying disease. Chagas and diphtheria
are two examples of diseases which must be treated to avoid fatal