Myocarditis

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Myocarditis is an inflammatory disease of your heart muscle. It can affect your heart’s ability to pump blood, as well as cause irregular heartbeats.

 

People who experience mild myocarditis often recover, but myocarditis can progress and result in a weakened, enlarged heart — ultimately leading to heart failure.

 

Myocarditis is challenging to diagnose due to the variety of symptoms a person may develop. Identifying and treating this condition is most effective when a variety of specialists work closely together.

 

Our Approach to Treating Myocarditis

At Houston Methodist, a range of experts work together to accurately diagnose and effectively treat myocarditis. This collaborative approach — as well as having access to advanced technology such as electrical mapping and EP-guided myocardial biopsies — enables our myocarditis experts to reach diagnoses that often elude other doctors.

 

Our multidisciplinary myocarditis team members include:

  • Cardiologists specializing in heart failure
  • Interventional cardiologists
  • Cardiac pathologists
  • Cardiothoracic surgeons

 

In addition, our physician-scientists lead the nation in studying heart inflammation and its triggers. Our commitment to research is helping doctors worldwide more accurately diagnosis this condition — so life-saving treatments can begin in a timely manner. We’re also conducting research to improve the understanding of how the immune system affects myocarditis, as well as to find new therapies to treat this condition.

 

About Myocarditis

What Causes Myocarditis?

Myocarditis is an inflammatory disease of the heart muscle that can be caused by variety of infectious agents, systemic diseases, drugs and toxins.

 

Infectious myocarditis can be caused by viral, bacterial, fungal or parasitic infection.

 

Immune-mediated myocarditis can be caused by:

  • Allergens, including some drugs
  • Systemic diseases, such as sarcoidosis, lupus, rheumatoid arthritis and scleroderma

 

Toxic myocarditis can be caused by:

  • Drugs
  • Heavy metals, including copper, iron and lead
  • Radiation
  • Electrical shock

What Are the Symptoms of Myocarditis?

Myocarditis symptoms can range from mild to life-threatening, and symptoms can present in different ways in different people.

 

Symptoms of myocarditis can include:

  • Flu-like symptoms, including fatigue and achiness
  • Chest pain
  • New onset of heart failure symptoms, including shortness of breath, swelling and fatigue
  • Palpitations
  • Life-threatening symptoms, including severe heart rhythm abnormalities, heart muscle dysfunction and heart failure

How Is Myocarditis Diagnosed?

Cardiac imaging can be useful in diagnosing myocarditis, but an endomyocardial biopsy is the gold standard. Our experts use an endomyocardial biopsy, a catheter-based procedure, to collect heart tissue samples that can be used for laboratory analysis.

 

Before performing an endomyocardial biopsy, your doctor may use one of the following to help diagnose myocarditis:

Echocardiogram

Cardiac MRI

FDG PET scan

Biomarker tests looking for inflammatory markers, cardiac markers, viral components or viral-specific antibodies

How Is Myocarditis Treated?

Treatment of myocarditis is often targeted toward the immune system, with the goal being to reduce the inflammation. Our experts often use medications such as steroids, immunosuppressive drugs, immunoglobulins and interventions like plasmapheresis.

 

Sometimes, myocarditis presents in a particularly aggressive manner — called cardiogenic shock. This condition has a profound impact on the heart and immediate care is focused on life-saving support using mechanical pumps. Once stable, treatment becomes focused on reducing inflammation in the heart. In some rarer kinds of myocarditis, called giant cell myocarditis or fulminant myocarditis, you may need a heart transplant  after initial stabilization.

 

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