Myocarditis is inflammation of the heart muscle (myocardium) typically caused by viral infection, autoimmune processes or toxic agents. This condition ranges from subclinical disease to fulminant cardiogenic shock requiring mechanical support. Livasa Hospital provides comprehensive myocarditis evaluation and management with modern diagnostic techniques and evidence-based therapeutic approaches.

Understanding Myocarditis

The myocardium is the contractile muscle of the heart. When infected or inflamed, myocardial function deteriorates. Myocarditis can cause:

• Acute coronary syndrome-like presentations – Chest pain and troponin elevation

• Heart failure – Reduced ventricular function

• Arrhythmias – Life-threatening rhythm disturbances

• Sudden death – Particularly in young, previously healthy individuals

Aetiology

Viral causes (most common):

• Enterovirus (coxsackievirus, echovirus)

• Adenovirus

• Influenza, COVID-19

• Myocarditis parvovirus B19

Other causes:

• Autoimmune conditions (systemic lupus erythematosus, giant cell myocarditis)

• Medications (chemotherapy agents, certain antibiotics)

• Toxins (cocaine, heavy metals)

• Bacterial or parasitic infections (less common)

Clinical Presentation

Symptoms are variable:

Acute presentation:

• Chest pain (may mimic MI)

• Dyspnoea

• Palpitations

• Syncope

• Sudden cardiac death (fulminant cases)

Subacute/chronic presentation:

• Progressive dyspnoea

• Fatigue

• Arrhythmias

• Heart failure symptoms

Diagnostic Evaluation

Biomarkers:

• Troponin elevation (indicates myocardial injury)

• BNP/NT-proBNP elevation (indicates ventricular stress)

• Inflammatory markers (ESR, CRP)

Imaging:

• Echocardiography – Global or regional ventricular dysfunction

• Cardiac MRI – Gold-standard; detects myocardial oedema and fibrosis

• Cardiac CT – Alternative structural assessment

Invasive testing:

• Endomyocardial biopsy – For diagnosis confirmation; increasingly reserved for selected cases

ECG:

• Non-specific changes or ST-segment elevation (mimicking MI)

Management Approach

Supportive care:

• Bed rest during acute phase

• Activity restriction during recovery

• Haemodynamic monitoring

Medications:

• ACE inhibitors – Prevent remodelling

• Beta-blockers – Reduce workload

• Diuretics – For heart failure symptoms

• Antivirals – Limited evidence; occasionally used

• Immunosuppression – For autoimmune myocarditis (controversial)

Device therapy:

• Temporary mechanical support – For fulminant myocarditis

• LVAD or ECMO – For shock refractory to medical therapy

Endomyocardial biopsy:

• Allows diagnosis confirmation

• Guides immunosuppressive therapy decisions

• Reserved for selected cases

Prognosis

• Most viral myocarditis cases resolve with supportive care

• Fulminant myocarditis has high mortality if untreated

• Some patients develop chronic cardiomyopathy

• Excellent long-term outcomes in survivors with appropriate management

Why Choose Livasa Hospital?

• Cardiac MRI for definitive diagnosis

• Experienced cardiologists in myocarditis management

• Advanced haemodynamic support capability

• Comprehensive heart failure management

NAP – Contact Details

Livasa Hospital Mohali
Sector 71, Sahibzada Ajit Singh Nagar (SAS Nagar)
Mohali, Punjab – 160071
Phone: +91-80788 80788 (24/7 Emergency)
Website: www.livasahospitals.com

Call +91-80788 80788 for myocarditis evaluation at Livasa Hospital.