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myocarditis

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Definition
Myocarditis is an inflammation of the heart muscle from any cause.

What is going on in the body? 
Inflammation can change the heart in many ways. It can make it weaker and affect the way it functions. Inflammation can cause certain areas of the heart muscle to die. Sometimes only a small area is affected, but serious cases may involve the entire heart.

What are the signs and symptoms of the condition? 
In some cases, symptoms, such as fatigue or weakness, are very mild and not specific. Other symptoms and signs may include: Other symptoms are generally related to the cause.

What are the causes and risks of the condition? 
There are many causes of this condition, including:
  • infections, usually with a virus
  • autoimmune disorders, such as rheumatoid arthritis, which occur when a person's immune system attacks his or her own body
  • radiation therapy, which may be given to treat cancer in the chest
  • exposure to chemicals or drugs, such as cocaine or a medication used to treat cancer, called doxorubicin
  • pregnancy, which can very rarely produce severe inflammation of the heart
Other causes are possible, and sometimes the cause is unknown.

What can be done to prevent the condition? 
Often nothing can prevent this condition. Avoiding exposure to drugs known to cause this condition, such as cocaine, may prevent some cases.

How is the condition diagnosed? 
A doctor may suspect this condition after taking a person's health history and doing a physical examination. The doctor may order a variety of tests, including:
  • ECG, or heart tracing
  • chest x-ray
  • echocardiogram, an imaging test that uses ultrasound waves to look at blood flow and pressures within the heart
  • blood cultures to check for infection in the blood
  • other blood tests to check for alternative causes 
  • biopsy of the heart muscle, which involves taking a small piece of heart muscle for testing in the laboratory
What are the long-term effects of the condition? 
Often this condition is silent, causing few or no symptoms, and goes away on its own. Most people recover completely. Rarely, a person may develop permanent congestive heart failure, arrhythmias, and damage to the heart muscle, known as cardiomyopathy.

What are the risks to others? 
There are no risks to others.

What are the treatments for the condition? 
If an infection can be identified, antibiotics are sometimes helpful. If a biopsy of the heart muscle shows active inflammation, corticosteroids or other anti-inflammatory medications maybe useful.

A variety of medications can be used to treat the complications of this condition, such as congestive heart failure and arrhythmias. In severe cases, a person may need a heart transplant to survive.

What are the side effects of the treatments? 
All medications have possible side effects. For instance, diuretics may cause allergic reactions, dehydration, and salt imbalances. Medications used to treat irregular heartbeats may cause other irregular heartbeats, stomach upset, or allergic reactions. A heart transplant involves a risky surgery that can result in infections, bleeding, or death.

What happens after treatment for the condition? 
Most people fully recover from this condition. For others, heart function may get worse over time. This may lead to permanent heart muscle damage, such as dilated cardiomyopathy. In this condition, the heart muscle becomes thin and flabby, and is unable to pump blood effectively. Someone with this condition will need ongoing treatment.

How is the condition monitored? 
Routine visits to a doctor and monitoring of heart function are needed.

Author: Eric Berlin, MD
Reviewer: eknowhow Australia Medical Review Panel
Editor: Dr John Hearne
Last Updated: 12/09/2004
Contributors
Potential conflict of interest information for reviewers available on request
 


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