Myocarditis
Myocarditis Causes
Myocarditis typically has infectious causes ? including viral (e.g. enterovirus, Coxsackie virus, rubella virus, polio virus, cytomegalovirus, possibly hepatitis C), bacterial (e.g. brucella, Corynebacterium diphtheriae, gonococcus, Haemophilus influenzae, Actinomyces, Tropheryma whipplei, and Vibrio cholerae), spirochetal (Borrelia burgdorferi and leptospirosis), protozoal (Toxoplasma gondii and Trypanosoma cruzi), fungal (e.g. aspergillus), parasitic (e.g. ascaris, Echinococcus granulosus, Paragonimus westermani, schistosoma, Taenia solium, Trichinella spiralis, visceral larva migrans, and Wuchereria bancrofti), and rickettsial. In some cases, the cause may be immunological ? such as an allergic reaction, the body's rejection of a heart transplant, or the body's reaction to certain autoantigens (e.g. systemic vasculitis such as Churg-Strauss syndrome, Wegener's granulomatosis). Some cases were also found to have toxic roots. Drugs, toxins, and heavy metals are known to have resulted in myocarditis. Certain physical agents such as electric shock, hyperpyrexia, and radiation can be similarly fatal.
Myocarditis Definition
Myocarditis is a cardiology condition marked by an inflammation of the myocardium, the muscular part of the heart, due to either viral or bacterial infection.
Myocarditis Diagnosis
Electrocardiographic (ECG) results, elevated CRP, and/or ESR and increased IgM are the basis for suspecting the presence of myocardial inflammation. High levels of troponin or creatine kinase cardiac isoenzymes are indicative of myocardial damage. The most recommended diagnostic tool for myocarditis is still biopsy of myocardium, typically done in an angiography setting. Small samples of endocardium and myocardium tissues are taken and analyzed by pathologists through light microscopy as well as immunochemistry and special staining methods. A recent development in medical technology is the use of cardiac magnetic resonance imaging (cMRI or CMR) to detect visual markers for myocardium inflammation.
Myocarditis Symptoms and Signs
While symptoms are varied, myocarditis mostly manifests as an actual inflammation of the myocardium, or a weakening of the heart muscle that is secondary to the inflammation. Most patients have been found to exhibit severe chest pains, palpitations, and fever due to infections. Congestive heart failure is also a dominant sign, which may, in turn, result in edema, breathlessness, and hepatic congestions. Sudden death in young adults is the most disturbing of all the symptoms. In all reported myocarditis cases to date, an alarming 20% have resulted in sudden death.
Myocarditis Treatment
For bacterial infections, antibiotics are the treatment of choice. The specific type of antibiotics used depends on the type of pathogen and its sensitivity to antibiotics. Viral infections, on the other hand, cannot be managed with direct treatment. Therefore, symptomatic treatment is the only form of medical intervention for viral myocarditis. Additionally, ACE inhibitor therapy may also help in treatment.