What is Myocarditis

Myocarditis is an inflammation and weakening of the myocardium, the thick, muscular layer of the heart wall.

It is a rare disorder that is usually caused by viral, bacterial or parasitic infections such as mononucleosis, polio, influenza or rubella. It can also be caused by allergic reactions, or exposure to chemicals or certain medications.

Severe myocarditis can weaken the heart muscle to the point where it can no longer supply your body with enough oxygenated blood. There is also a risk of blood clots forming in the heart, which can lead to stroke or heart attack.

Symptoms of Myocarditis

A patient with myocarditis will experience the following symptoms:

• Chest pain
• Rapid or irregular heartbeat, arrhythmia
• Breathlessness
• Fluid retention
• Fatigue
• Fainting or dizziness
• Acute heart failure

Occasionally a patient suffering from myocarditis will experience no symptoms. In these cases the problem usually corrects itself.

Myocarditis in Children

When children develop myocarditis, they may experience the following:

• Breathing difficulties
• High temperature
• Gray or bluish discoloration of the skin
• Loss of appetite

Diagnosis of Myocarditis

To diagnose myocarditis, your doctor will take a medical history and perform a physical examination where she will listen to your heart with a stethoscope, listening for unusual sounds, such as murmurs or abnormal heart rhythms.

In order to make a positive diagnosis, your doctor will probably perform an Electrocardiogram (ECG) to check the electrical patterns of your heart, abnormal rhythms and signs of a weakened or damaged heart muscle.

She may also choose to take a chest x-ray, to look for build-up in the fluid in your lungs.

Treatment of Myocarditis

The first course of treatment is usually to treat the infection that caused the myocarditis in the first place. Your doctor may prescribe bed rest and medication to help your heart rest and heal on its own.

If, however, you have rapid or irregular heartbeats a period of hospitalization may be recommended. In most cases myocarditis patients will make a full recovery. However, in more severe cases aggressive therapy may be required to facilitate recovery.

What is Pericarditis?

Pericarditis is an inflammation of the pericardium, the thin layer of tissue that surrounds the heart. Pericarditis has many causes including infection, exposure to certain medications, and radiation therapy.

In young, otherwise healthy patients, pericarditis can be caused by viral infections, such as (you guessed it) mononucleosis.

Symptoms of Pericarditis

Similar to myocarditis, the most common symptom of pericarditis is chest pain. This pain is usually felt below the breastbone and/or below the ribs on the left side of the chest.

The pain may worsen when the patient lies down, and better when he sits up or leans forward. Breathing will worsen the pain as the lungs and heart move in the chest, rubbing against the irritated pericardium.

Other symptoms include:

• Shortness of breath when lying down
• Feelings of fatigue, weakness, or sickness
• A dry cough
• Abdominal swelling
• Low grade fever

Diagnosis of Pericarditis

In order to diagnose pericarditis, the doctor will need to:

• Take a medical history, including what your symptoms are and whether or not you’ve recently had any infections, such as mono.
• Complete a physical examination. The doctor will listen to your heart, checking for scratchy sounds, called pericardial rub, that the heart makes as it rubs against the swollen pericardium. The doctor may also check for swollen ankles and feet and distended veins in the neck.
• Take an electrocardiogram (ECG) – (See above under myocarditis for explanation of ECG).

Usually these procedures gather sufficient information for the doctor to make a diagnosis of pericarditis.

Treatment of Pericarditis

Your doctor may prescribe anti-inflammatory drugs, such as aspirin or ibuprofen, to relieve pain and reduce the swelling in your heart.

Bed rest is also a common recommendation for pericarditis. If you have more severe pain, you may be given a narcotic to make you more comfortable.

Recovery time is usually one to three weeks, though one in five patients will report a relapse within months. In some severe cases, pericarditis surgery may be recommended to drain the excess fluid.