The human heart is an organ that pumps blood throughout the body through the circulatory system. It supplies tissues with oxygen and nutrients, and removes carbon dioxide and other waste products. These processes take place by contracting the heart muscle and relaxing as the heart fills with blood.
Inflammation of the heart muscle (myocarditis, inflammation of the myocardium) is a condition caused by a reaction to internal or external factors, such as infections caused by bacteria or a virus. Some inflammatory processes occur when a person's immune system mistakenly believes that organs in their body are foreign. Sometimes inflammation can lead to tissue scarring, cardiomyopathy (myocardial damage), or arrhythmias (abnormal heart rhythms).
Reasons
Myocarditis is a fairly rare disease. And often the exact causes of its occurrence may not be known. Most often, the disease occurs against the background of infections. They can be, for example,mycoplasmosis, chlamydia, or Lyme disease. As the patient's condition worsens, the ability of the heart to pump blood is impaired. This leads to a decrease in blood supply to all organs. Ultimately, the force of contractions of the heart decreases and the ability to supply blood to the body deteriorates.
The causes of inflammation of the heart muscle are divided into infectious and non-infectious. Infectious include:
- viruses (coxsackievirus, influenza, herpes, HIV, parovirus, hepatitis C, cytomegalovirus, measles, polio, chickenpox, rubella, rabies);
- bacteria (streptococcus, staphylococcus, tuberculosis);
- spirochetes (syphilis, Lyme disease);
- fungus (candidiasis, histoplasmosis, aspergillosis);
- protozoal infections (Chaga disease, toxoplasmosis, schistomiasis).
Non-infectious causes of inflammation of the heart muscle can be:
- Hypersensitivity to certain antibiotics, chemotherapy drugs, such as Doxorubicin, Zidovudine, Dobutamine, Cytoxan.
- Toxins - anthracyclines, drugs (cocaine, methamphetamine), alcohol, heavy metals (lead, arsenic, carbon monoxide), radiation, certain chemicals, poisons, etc.
- Systemic diseases - sarcoidosis, collagen vascular disease, Wegener's disease, thyrotoxicosis, hypereosinophilic syndrome, celiac disease, acute rheumatic fever, lupus.
- Idiopathic (unspecified) etiology.
Mosta common cause of inflammation of the heart muscle in a child or adult is a viral infection, such as the flu or a cold. The virus itself can enter the heart and damage the muscle. The cells of the body's immune system can also damage the heart muscle as they fight infection.
Symptoms
Signs of inflammation of the heart muscle depend on the cause and severity of the disease. For example, many people with myocarditis due to the Coxsackievirus do not have any symptoms of the disease. The only indicator of heart muscle inflammation may be a temporary abnormal result on an electrocardiogram (ECG), a test that measures the electrical activity of the heart. Or an echocardiogram (ultrasound of the heart) may show some changes, such as reduced myocardial contractility.
Typical symptoms of inflammation of the heart muscle include chest pain and arrhythmias that occur during or shortly after an infectious disease. In most cases, myocardial injury is mild, heals quickly and completely, and does not affect the pumping function of the heart. However, inflammation of the heart muscle can sometimes cause extensive damage, leading to myocardial failure. This life-threatening condition requires prompt care in a specialized facility. Fortunately, this condition is quite rare.
Common symptoms of inflammation of the heart muscle in adults include:
- chest pain;
- arrhythmia (abnormally fast, slow or irregular heartbeat);
- sudden loss of consciousness (fainting);
- temperature increase;
- pain and swelling in the joints;
- signs of heart failure (shortness of breath, leg swelling);
- tired.
A child with myocarditis may show the following signs:
- temperature increase;
- tachycardia or arrhythmia;
- rapid breathing;
- difficulty breathing, especially when moving;
- appearance of restlessness or irritability;
- bad dream;
- refusing food;
- excessive sweating;
- weakness, lethargy, apathy, fainting;
- rare urination;
- pale integuments of arms, legs (cyanosis);
- vomit.
Older children may complain of the following ailments:
- cough;
- nausea;
- abdominal or chest pain;
- swelling in legs, feet and face;
- shortness of breath or trouble breathing at rest, at night;
- weight gain.
Diagnosis
Diagnosing inflammation of the heart muscle is often quite difficult. This is because the symptoms of myocarditis are similar to those of other heart, lung, or flu conditions.
To make a diagnosis, a specialist takes an anamnesis. The doctor interviews the patient and obtains detailed information about any symptoms, chronic diseases andtransferred infections. Then an examination is carried out. When listening to the heart with a stethoscope, a specialist can detect a rhythm disorder. On physical examination of the patient, external manifestations of myocarditis can be detected, for example, swelling of the limbs, swelling of the joints, or pallor of the skin.
In addition, additional research may be needed. They will give more complete information about the condition of the heart and how well it works. These examinations can be:
- Chest x-ray - a picture of the heart and lungs, showing the blood vessels, ribs and bones of the spine.
- Echocardiography. This test uses sound waves to evaluate the function and structure of the heart muscle and valves.
- An electrocardiogram is a test that records the electrical activity of the heart.
- MRI (Magnetic Resonance Imaging) is a non-invasive procedure that uses radiation to obtain a detailed picture of the structure and functions of the heart during its operation.
- A heart biopsy is a procedure to obtain a sample of heart muscle tissue to check for signs of infection and inflammation. The material is obtained through a cardiac catheterization, in which a long, thin tube (catheter) is inserted into an artery or vein in the groin, arm, or neck.
- Blood testing for infections, checking liver and kidney function to look for antibodies against viruses.
Treatment
How to treat inflammationheart muscle? First of all, the choice of therapy depends on the cause and severity of the disease. Options include basic pharmacological treatment for ventricular dysfunction, vasopressor placement, immunomodulatory, immunosuppressive, antiviral therapy, assistive devices, or heart transplantation.
In the absence of symptoms of inflammation of the heart muscle, medication is rarely prescribed. To normalize the condition, it will be enough for the patient to observe bed rest for some time, to limit physical activity. Patients are also prescribed a low-s alt diet.
In severe pain, inflammation of the heart muscle is treated with painkillers.
Myocarditis without treatment can lead to chronic dilated cardiomyopathy (stretching of the cavities of the heart with irregular heartbeat). In this case, the risk of death increases.
Medicated treatment
How to relieve inflammation of the heart muscle? To do this, eliminate the causes of the disease. Depending on the nature of the inflammation, the attending physician prescribes appropriate medications.
Medication for myocarditis may include:
- Antimicrobials (antibiotics) to fight bacterial infection.
- Steroids to reduce swelling.
- Intravenous immunoglobulin to increase the amount of antibodies needed to fight the inflammatory process.
- Diuretics to remove excess water from the body. This reduces the load on the heart.
- Drugs to normalize heart rate. These include ACE (angiotensin-converting enzyme) inhibitors, beta-blockers, and angiotensin receptor blockers, which may be prescribed to treat pulmonary hypertension.
- Medicines that thin the blood to reduce the risk of blood clots.
- Medicines for the treatment of heart failure in the weakening of the muscles of the heart.
In rare cases, autoimmune diseases can be treated with drugs to suppress the body's immune response.
Surgical treatment
Patients with more severe cases of myocarditis may need surgery or other interventions.
The following types of treatment are distinguished:
- Ventricular assist devices. They are a pump used when the heart cannot pump enough blood. Some of them are located inside the body, while others have parts inside and outside.
- Pacemaker. Installed in patients with bradycardia (slow heartbeat) and heart failure.
- Intra-aortic balloon counterpulsation (IABP) is a machine that helps the heart pump blood throughout the body. It is used when the organ is unable to pump enough blood on its own. A special balloon is inserted through the femoral artery into the groin and threaded into the aorta. The balloon deflates and inflates, saturating the blood with oxygen, and, thereby,reduces stress on the heart.
- ECMO (extracorporeal membrane oxygenation). In this case, the blood is driven through a special apparatus to increase the amount of oxygen, and then poured back into the body.
- Heart transplantation. An organ transplant may be needed in very severe cases where the disease cannot be cured with medication. The patient is transplanted with an artificial or donor heart. The disadvantage of this operation is the need for lifelong use of immunosuppressive drugs. This therapy is mandatory to eliminate the risk of organ rejection.
Forecast
The duration and outcome of treatment may vary depending on the cause of the disease and the general he alth of the individual. In most cases of myocarditis caused by viruses or bacteria, the patient's condition improves with treatment without any complications. Approximately a third of people who have suffered inflammation of the heart muscle fully recover within some time. Others may have long-term heart failure. In severe cases, inflammation of the heart muscle does not go away without a trace, and the patient requires lifelong maintenance medications. In situations where inflammation and damage to the heart is critical, the only treatment option is a heart transplant.
Consequences
If left untreated, inflammation of the heart muscle can lead to other complications, such as:
- Cardiomyopathy is a disease in whichthe muscle tone of the heart decreases, and its ability to pump blood throughout the body decreases.
- Heart failure is a violation of blood circulation in the body.
- Pericarditis is a disease that causes inflammation of the pericardium. The pericardium is a fluid sac that surrounds the heart.
Prevention
Myocarditis caused by infections can theoretically be avoided by maintaining daily hygiene, especially hand washing. Myocarditis of infectious and viral etiology can be prevented by immunization. HIV infection can be avoided by using safe sex practices and avoiding intravenous drug use.
Measures to prevent inflammation of the heart muscle include, among other things:
- Eating a he althy and balanced diet.
- Choosing low-fat foods. This can include skinless poultry, non-fried fish, beans, milk and low-fat dairy products.
- Eating low-sugar foods.
- Moderate physical activity.
- Do not self-medicate. Medications should only be taken as prescribed by the attending physician.
- Maintaining a he althy lifestyle. Quit smoking, alcohol and drugs.
- Regular medical examination.
- Support optimal body weight.
- Finding ways to self-control and manage stress.
- Reducing s alt intake.
- Rest and long sleep.
When to apply?
If you experience symptoms of myocarditis, especially after a recent infectious disease, you should contact your doctor.
In cases of persistent and increasing chest pain, swelling or breathing problems, especially with previous inflammation of the heart muscle, contacting a medical facility should be immediate.
In closing
Inflammation of the heart muscle. What it is? This is an inflammation of the muscular walls of the heart. Early diagnosis of the disease is key to preventing complications.
The causes and treatment of inflammation of the heart muscle are diverse. There are infectious, toxic, autoimmune etiologies. Infectious, especially viral, most often occurs in children. The choice of type of treatment for inflammation of the heart muscle depends on the cause of the disease and its severity. Regardless of the type of therapy, the goal is to support the work of the heart. In the absence of symptoms of inflammation of the heart muscle, treatment in adults and children is not prescribed.
Myocarditis affects children differently depending on the cause, general he alth and age of the child. Most of them fully recover from inflammation of the heart muscle with appropriate treatment. At the same time, others may develop chronic heart failure. Newborns are at higher risk of serious complications.
For severe life-threatening symptomsinflammation of the heart muscle treatment should be started immediately. In these cases, the heart can be so severely damaged that only an organ transplant is needed to save the patient.
