myokardiitti

Myokardiitti, or myocarditis, is inflammation of the myocardium, the heart muscle. It can result from infections (most commonly viral), autoimmune processes, toxins or drugs, and systemic diseases. In many cases the exact cause is not identified.

Clinical presentation ranges from no symptoms to chest pain, shortness of breath, fatigue, or palpitations. Severe cases can cause heart failure, arrhythmias, or cardiogenic shock, particularly in fulminant forms.

Diagnosis uses clinical history, examination, and investigations. Elevated troponin and inflammatory markers are common. Electrocardiography may show arrhythmias or ST-T changes. Echocardiography assesses heart size and function, and cardiac magnetic resonance imaging can detect edema and myocardial scarring. Endomyocardial biopsy is reserved for selected cases where diagnosis remains uncertain or specific therapies are considered.

Treatment aims at supporting heart function and addressing the underlying cause. This may include medications for heart failure or rhythm control, activity restriction during recovery, and discontinuation of offending drugs or toxins. Immunosuppressive therapy or antiviral treatment is used only in specific forms. Most patients recover, but some develop lasting dilated cardiomyopathy.

Prognosis is highly variable. Many cases resolve, especially in younger people, but myocarditis can lead to chronic heart disease or sudden death, particularly in athletes. Incidence is uncertain and often underdiagnosed. Prevention focuses on reducing infection exposure and avoiding cardiotoxic substances.