Myocarditis

Myocarditis is defined as ‘inflammation of the heart muscle ‘ . This muscle is called the myocardium and its function is to give the heart mobility. It contracts to send blood out of the organ and then relaxes until the heart fills up again. 

If the myocardium  becomes inflamed, the pumping function is no longer as efficient because of the same swelling and because of damage to the cells. This, of course, constitutes a great risk to health, and even life.

At present, it is not known exactly what percentage of people this disease affects. This is because in many cases myocarditis does not cause symptoms. What is known is that it can occur at any age, even in children.

What Causes Myocarditis?

It is known that in at least 50% of cases what causes myocarditis is an infection  caused by viruses, fungi, parasites or bacteria. It often appears after a diarrhea, cold, or flu.

Other common causes of myocarditis include the following:

• Radiation.
• Allergic reaction to medications.
• Autoimmune processes  that give rise to inflammations.
• Exposure to some elements of the environment, such as heavy metals.

It has been established that some diseases such as rheumatoid  arthritis, rheumatic fever and lupus are also associated with myocarditis. On several occasions it is impossible to determine the exact cause of the disease.

Processes involved in myocarditis

The body reacts to inflammation of the heart muscle by activating the immune system. It sends out antibodies to fight the agent that causes inflammation. However, the chemicals produced by these cells can damage the heart muscle.

If many cells are damaged, the result is a thick, swollen, and weakened heart. When this process occurs very quickly, it can lead to heart failure and even sudden death.

The normal thing is that the heart tries to regenerate itself. This is accomplished by exchanging damaged or dead myocardial cells for scar tissue. This tissue is rigid and, therefore, does not contribute to the pumping of the heart.

When scar tissue is extensive, it could lead to congestive heart failure or dilated cardiomyopathy.

Symptoms of the disease

The symptoms of myocarditis are highly variable. In fact, in some cases the disease runs its course without presenting symptoms. It should be noted that there are acute myocarditis and chronic myocarditis. Each of them has its own symptoms.

Acute myocarditis has symptoms similar to those of heart failure. The most relevant are the following:

• Strong and stabbing pain in the chest, which is located behind the breastbone.
• Tachycardia.
• Bluish discoloration of the skin and mucous membranes, or paleness.
• Difficulty breathing.
• Palpitations
• Inflammation of the liver and spleen.
• Accumulation of fluid in the legs.

The symptoms of chronic myocarditis are less obvious. In general, there is a feeling of weakness and decay, fatigue and shortness of breath with minimal efforts, variations in appetite, pain in the extremities and weight loss.

Diagnosis and evolution

The diagnosis of myocarditis is problematic, since the symptoms are not very specific and therefore are easily confused with those of other diseases. Usually the first thing that is done is a clinical examination that aims to verify the existence of symptoms and gather information on possible recent infections.

If there are suspicions, a chest X-ray may be ordered to establish whether there is fluid accumulated in the lungs. However, the most common is that an EKG or echocardiogram is ordered. These allow us to appreciate in detail the functioning of the heart.

The most accurate method is endomyocardial biopsy. The results of the same are conclusive, since this test shows directly if the myocardium is inflamed or not. This test is usually ordered when chronic myocarditis is suspected.

Acute myocarditis progresses satisfactorily in most cases. It heals on its own, without leaving sequelae. Sometimes it gets complicated and can lead to more serious problems and death. In other cases, it leads to permanent heart failure. It all depends on the state of health of the patient and the cause that gave rise to the disease.