Complications and treatment of myocarditis

The article is professionally consulted by Master, Doctor Do Nguyen Thuy Doan Trang - Head of Extracorporeal Circulation Team - Cardiovascular Center - Vinmec Central Park International General Hospital. The doctor is a leading expert in Extracorporeal Circulation in cardiac surgery and cardiac resuscitation, Cardiovascular medical treatment.

Myocarditis is inflammation of the heart muscle (including myocytes, interstitial spaces, and blood vessels in the heart). This is a dangerous disease, if there is no timely treatment regimen for myocarditis, the patient can die after only 24-48 hours.

Myocarditis is acute or chronic inflammation of the heart muscle. The disease is especially dangerous when it is common in young people and has a rapid mortality rate if not diagnosed in time.
In the early stages, the clinical symptoms of myocarditis are often mild, patients are easily confused with common colds and are easy to ignore. In case of inflammatory myocarditis, the patient will have symptoms of high fever up to 41 degrees Celsius, muscle and joint pain, fatigue, heart palpitations, low blood pressure, weak heartbeat, chest pain, shortness of breath ....Usually, the disease progresses quickly - slowly depending on the cause of the disease and the extent to which the heart muscle is affected. In some cases, without an accurate diagnosis and timely treatment of myocarditis, patients with myocarditis may die quickly after 24-48 hours.
To diagnose myocarditis, the doctor will order monitoring through echocardiography, electrocardiogram, chest X-ray, cardiac MRI, blood tests, coronary angiography and myocardial biopsy.

Each cause of myocarditis will have different symptoms and degrees of health effects. The main causes include: Bacteria, viruses, spirochetes, fungi, radiation, drugs and chemicals. Some other causes such as: Postpartum effects, alcohol, ... even myocarditis has no cause.
Experts agree that the most common cause of myocarditis is Enteroviruses (70 serotypes): Coxsackie A4; A16; B1-5. These viruses account for 50% of cases of viral myocarditis directly from nasal secretions, heart tissue, throat, and feces of acute patients. Myocarditis may be due to increased susceptibility or secondary to a drug reaction. The severity varies from no symptoms or mild symptoms to severe, rapidly progressing disease.
Myocarditis is often severe and has the highest mortality when caused by viruses, diphtheria in children, myocarditis with heart failure, arrhythmias, and embolism.

Myocarditis is a dangerous and complex disease, often accompanied by endocarditis and pericarditis. Common complications of myocarditis include: Decompensated heart failure, peripheral embolism due to blood clots, severe arrhythmias,
Viral myocarditis is often missed in diagnosis but progresses. in a very short time, there is a high risk of death and sudden death. When the virus enters the body, it usually causes a sore throat, fever, and after 5-7 days, it will invade the heart and other organs. However, this process is often confused with common respiratory diseases.
The virus attacks the heart, damaging heart muscle cells, causing cardiac arrhythmias, reducing myocardial contractility and leading to cardiovascular collapse. Some cases of patients die after only 1 to 2 days despite being detected early.
To prevent complications of myocarditis, patients should not be subjective with common cold symptoms, when there are signs of high fever, muscle pain, chest tightness, shortness of breath, need to see a doctor soon to timely diagnosis and follow-up treatment of infections.

Depending on the cause of the disease, there will be different treatment directions for myocarditis, but the most important thing is to treat it early and enough time, not to arrhythmia, heart failure because myocarditis is a disease with a high rate. high mortality.
4.1 Symptomatic treatment Increase rest, reduce salt intake; Intermittent oxygen breathing; Treatment of cardiac arrhythmias.
Treatment of heart failure with drugs:
Heart medications: dobutamine, dopamine, milrinone Diuretics: Take each 2-3 days. Salt-reducing diuretics such as lasix, hypothiazide. K+-sparing diuretics: Aldacton Adequate potassium supplementation Prophylaxis: anticoagulants or platelet aggregation inhibitors Treatment of arrhythmias: drugs, urgent cardioversion or implantation of a defibrillator (ICD) ) 4.2 Treat the cause According to standard treatment protocol
4.3 Mechanical support Heart failure patients with hemodynamic instability and unresponsive to drug therapy may need instrumental circulatory support: VAD (ventricular assist device) or ECMO (Extracorporeal Peripheral Blood Oxygenation)
4.4 Heart Transplant Patients with chronic myocarditis with end-stage decompensated heart failure are candidates for heart transplantation.
Treatments for myocarditis need to be done under the direction and supervision of the doctor. To prevent myocarditis, people must not let their guard down against common bacterial and viral infections. When there are signs of the disease, it is necessary to quickly go to a reputable medical facility to be diagnosed by a specialist. timely diagnosis and treatment.