It seems like everyone is falling ill these days. What many might not realize is that infectious inflammatory diseases can lead to inflammation of the heart muscle, known as myocarditis. Interestingly, many individuals with myocarditis may not even be aware they have it, and the condition could resolve without any treatment. However, in some cases, this inflammation could progress to chronic heart failure.
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How is myocarditis related to winter illnesses?
Myocarditis is an inflammatory disease that involves the infiltration of heart muscle tissue by inflammatory cells. The most common cause of myocarditis is a transient viral illness. So far, 20 types of viruses have been identified that can cause myocarditis. These include enteroviruses, which cause intestinal inflammation, mouth ulcers, and rashes; adenoviruses, which cause eye and throat inflammation; viruses associated with mononucleosis (EBV, CMV); influenza viruses; hepatitis viruses (Hepatitis C, Hepatitis B); and most recently, the coronavirus (COVID-19).
How can someone who has contracted one of these diseases know if they might also have myocarditis?
Most people may not notice because they might attribute the symptoms to the disease they already have, whether it's the flu, COVID-19, mononucleosis, or other illnesses.
What are the warning signs?
The clinical symptoms of myocarditis include weakness, heart palpitations, and chest pains. In most cases, a person with myocarditis may not receive a clinical diagnosis at all. This is because, following their viral illness, they might take symptomatic treatment common for flu-like diseases, such as pain relievers or fever reducers, which can also help alleviate chest pains.
More severe cases of myocarditis can lead to more intense chest pains that don't subside with treatment using common medications like Acamol. In such cases, the patient usually ends up in the emergency room.
How is myocarditis diagnosed and when is it dangerous?
The diagnosis of myocarditis is made in medical facilities, such as hospitals or clinics, using a combination of EKG findings, blood tests, and an echo of the heart. The final diagnosis is made using a magnetic resonance imaging test of the heart.
Recuperation and preventative care
Most cases of myocarditis resolve without any lasting effects. Even patients with severe conditions who require hospitalization typically recover within a few weeks and do not suffer from long-term consequences of the disease. Treatment includes managing symptoms such as pain and fever, ensuring complete rest, and monitoring for irregular heart rhythms.
In some instances where there's a decrease in heart muscle function, specific medication commonly used in treating heart failure is required. After being discharged from the hospital, patients are advised to avoid physical activity for a period of six months. Despite these measures, it's still crucial to diagnose and treat myocarditis to prevent potential complications.
A very small percentage of cases can deteriorate into a severe inflammatory disease causing acute and intense heart failure, where the patient might develop a critical condition with rapid heart failure. This is referred to as "fulminant myocarditis". In the past, this condition was associated with very high mortality rates. However, today, a significant percentage of individuals suffering from this syndrome can be saved, thanks to mechanical heart support options like the ECMO machine that simulates heart and lung function.
In addition to mechanical support, patients with fulminant myocarditis require a biopsy of the heart muscle tissue to identify a specific cause of the disease. Identifying the specific cause allows treating teams to administer specific treatment against that cause.
Dr, Shelly Shumilov KlipperPhoto: Inbal MarmariRegardless of the specifics, caution is required for a year, particularly in cases where the patient suffers from persistent chest pain that doesn't respond to common pain relievers like Acamol and is accompanied by heart palpitations, shortness of breath, or fainting. As the famous saying goes: Better safe than sorry.
Getting vaccinated against the flu and COVID-19 is also recommended, in line with the Ministry of Health's guidelines and depending on the individual's age and overall health status. Consultation with a doctor is advised in these matters. Moreover, in the event of a fever, it's recommended to refrain from physical activity due to the potential risk of heart muscle involvement and increased risk of heart rhythm disturbances during such activity.