Myocarditis is an inflammation of the heart muscle (myocardium), but may affect any layer of the heart wall. Symptoms can include chest pain, a rapid heartbeat, swelling in the lower extremities, difficulty catching your breath, unusual tiredness and flu-like symptoms. Severe cases can lead to heart failure and life-threatening arrhythmias.
Why Choose The Ohio State University Wexner Medical Center?
Some people who have severe myocarditis may require temporary support with a ventricular assist device (VAD), also known as a heart pump. Once stabilized, the ventricular assist device could be removed. The Ohio State University Wexner Medical Center’s ventricular assist devices program has grown by 179 percent for implanted devices in recent years. The Wexner Medical Center was one of the nation’s leading enrollers in a randomized multi-center trial testing the effectiveness of a second-generation ventricular assist device that is smaller, lighter and longer lasting than previous models. The device recently received Food and Drug Administration approval as a destination therapy for heart failure patients.
The most severe cases of myocarditis may result in the need for a heart transplant. Since completing our first heart transplant in 1986, The Ohio State University Medical Center is the only adult heart transplant center in central Ohio.
What Is Myocarditis?
Myocarditis is inflammation of the heart muscle. It can present acutely or have been present for a longer duration, unknown to the patient. The inflammation may be present in a small or large (diffuse) area of the heart. It can weaken the heart causing it to fail in supplying an adequate blood supply throughout the body.
What Causes Myocarditis?
The immune system fights infection in the body. When infection affects the heart, the cells that fight the infection can cause damage to the heart.
Myocarditis can be caused by an infection from a virus or a pathogen, such as bacteria and fungi.
Some of the viruses that can cause myocarditis include:
- Hepatitis C
Bacteria that can cause myocarditis include:
Fungi that can cause myocarditis include:
Some diseases and medications also can cause myocarditis. In many cases, a clear cause is not identified.
Some cases of myocarditis resolve without treatment.
Cases that are caused by bacterial infection may be treated with antibiotics.
Patients whose symptoms include irregular or rapid heartbeats may need medication to regulate the heartbeat. These include angiotensin-converting enzyme (ACE) inhibitors, diuretics, beta blockers and angiotensin II receptor blockers (ARBs) may be prescribed to treat pulmonary hypertension.
In some cases, drugs that reduce the immune response may be used, but these cases are rare.
Surgery and Other Treatment
Patients who have more severe cases may need surgical or other intervention, including:
Ventricular assist device (VAD) – A type of heart pump used when the heart cannot pump enough blood. Some are placed inside the body, and others have parts inside and outside the body. Ohio State’s Medical Center was one of the nation’s leading enrollers in a randomized multi-center trial testing the effectiveness of a second-generation VAD that is smaller, lighter and longer lasting than previous models. The device recently received Food and Drug Administration approval as a destination therapy for heart failure patients.
Intra-aortic balloon pump – A machine that helps the heart pump blood throughout the body. It is used when the heart is not able to pump enough blood by itself. The balloon is put in place via cardiac catheterization through an artery in the groin and threaded up to the aorta. The machine helps move the blood by inflating and deflating the balloon with each heartbeat.
ECMO (extracorporeal membrane oxygenation) – This treatment circulates blood through a machine to increase its oxygen content, and returns the oxygenated blood to the body.
Heart transplantation may be necessary in very severe cases.
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