What is myocarditis:
Myocarditis is inflammation of the heart muscle layer caused by an invasion of myocardium by viruses, bacteria, or toxins. The initial stage of the disease tends to be ignored due to symptoms of upper respiratory tract infection and gastrointestinal tract infection. As a result, the disease could further progress to heart failure and shock.

 

Causes of myocarditis:
There is a wide range of causes of myocarditis, which can result in localized myocardium or diffuse inflammation due to the following:

  1. Infectious pathogens, such as viruses, bacteria, chlamydia, rickettsia, fungi, protozoa, etc.
  2. Non-infectious causes, including autoimmune diseases, drug allergic reactions, toxic reactions, and radiotherapy.
  3. Primary diseases like acute necrotizing eosinophilic myocarditis and giant cell myocarditis.
  4. Connective tissue diseases, such as rheumatoid arthritis and measles.

 

Symptoms:
There are diverse clinical manifestations of myocarditis. Because its symptoms are often masked by systemic symptoms of viral infection, they tend to be ignored. Patients often experience symptoms of upper respiratory tract infection or gastrointestinal infection and other viral diseases before the onset of illness, such as fever, cough, sore throat, vomiting, diarrhea, muscle aches, fatigue, paleness and palpitations, chest tightness, chest pain, tachycardia or bradycardia, arrhythmia, etc., or even shock.

Patients experiencing symptoms mentioned above are not necessarily suffering from myocarditis. If you experience the symptoms mentioned above, please go to the Heart Surgery Hospital for medical treatment.

 

Differential diagnosis:
Myocarditis can be diagnosed using X-ray, electrocardiogram, cardiac ultrasound, cardiac catheterization, and MRI. However, myocardial biopsy is still the most commonly used clinical diagnostic method.

 

Treatment:
The treatment of myocarditis is through supportive care for left heart failure and arrhythmia. The direction of care is divided into internal medical and surgical treatment.

  1. Internal medical treatment:
    1. For general treatment, antiviral drugs can be used to treat primary disease, and antibiotics can be used to treat bacterial infections. If myocarditis is caused by drugs or immune reactions, then drugs that suppress allergic reactions should be used.
    2. For the treatment of heart failure, cardiotonic agents, diuretics, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers can be administered.
  2. Surgical treatment:
    1. Heart transplantation may be required when internal medical treatment fails to improve the disease condition.


Healthcare key points to prevent myocarditis:

  1. Prevention of infections: Respiratory tract infections and intestinal infections should particularly be prevented. People should pay attention to maintaining good health, balanced nutritional intake, and appropriate exercise to prevent colds. During any influenza epidemic, it is advised to reduce visits to public places. When necessary, it is preferable to wear a mask and wash hands frequently.
  2. Proper rest: It is necessary to avoid emotional agitation or excessive physical exertion. Therefore, vigorous exercise should be avoided to prevent myocardial fatigue, which may aggravate the disease condition. Patients experiencing acute onset should stay in bed for 2 to 4 weeks and for 2 to 3 months when the disease condition is severe. For daily life work and rest, it is necessary to reduce staying up late, socializing, etc.
  3. Enhancement of immunity: In daily life, people who are prone to colds should pay attention to nutrition, drink plenty of water, rest more, and choose appropriate exercise to strengthen their physical fitness. People with low immunity should pay more attention to colds prevention.
  4. Diet: Eat more high-protein, high-calorie, and high-vitamin foods; avoid spicy, grilled, and fried foods.
  5. Early diagnosis and early treatment: Those who experience changes in their body, especially when having a cold, should seek medical attention for diagnosis and treatment as soon as possible. Especially for severe viral colds, in cases of a significant increase in heart rate, shortness of breath, paleness, or bruising, it is necessary to consult a doctor in a timely manner. Do not take such situations lightly, so as not to miss an opportunity for early treatment.
  6. In recent years, there has been a declining trend in the age groups suffering from myocarditis. Young and middle-aged people should not rely on their health and fail to seek medical treatment in time. It is not advisable to exercise vigorously during illness to avoid any intensified reproduction of the virus in the myocardium.
  7. Although myocarditis is not a very common disease, it is necessary to be extra careful during flu epidemic seasons.
  8. Those who experience repetitive upper respiratory tract and gastrointestinal tract symptoms with tachypnea, chest tightness, dizziness, and arrhythmia should seek medical treatment at a heart surgery hospital as soon as possible!

 

References

  1. Humg,Y., Lin,W. H., Lin,C, S., Cheng,S, M., Tsai,T, N., Yang,S, P., & Lin,W, Y. (2016). The prognostic role of QTc interval in acute myocarditis. Acta Cardiologica Sinica, 32(2), 23-230. https://doi.org/10.6515/acs20150226a
  2. Ko, Y. F. (2018). A critical nursing experience of caring for an adolescent patient with myocarditis. Chang Gung Nursing, 29 (3), 491-501.https://doi.org/10.6386/CGN.201809_29(3).0014
  3. Sawalha, K., Abozenah, M., Kadado, A. J., Battisha, A., Al-Akchar, M., Salerno, C., Hernandez-Montfort, J., & Islam, A. M. (2020). Systematic review of COVID-19 related myocarditis: Insights on management and outcome. Cardiovascular Revascularization Medicine: including molecular interventions, S1553-8389(20)30497-8. Advance online publication. https://doi.org/10.1016/j.carrev.2020.08.028
    Quiz
    Please answer the following questions:
    Nursing Instruction Satisfaction
    Please log in to rate