myokardit

Myokardit, commonly referred to as myocarditis, is inflammation of the myocardium, the heart muscle. The condition can affect people of any age but is most often seen in young adults and athletes. It ranges from a mild, self-limited illness to a fulminant disease that causes heart failure or dangerous arrhythmias.

Causes include viral infections (for example Coxsackie B and adenovirus), other infectious agents (bacteria, fungi, parasites), autoimmune or immune-mediated processes, hypersensitivity to drugs, toxins such as alcohol or cocaine, and less commonly systemic diseases.

Symptoms vary and may include chest pain or pressure, shortness of breath, fatigue, palpitations, fever, or syncope. Some patients have signs of heart failure or circulatory compromise. The presentation is often non-specific and may mimic other cardiac conditions.

Diagnosis relies on a combination of history, examination, and tests. Electrocardiography may show arrhythmias or ST-T changes; blood tests often reveal elevated troponin and inflammatory markers. Echocardiography assesses heart function. Cardiac MRI can detect myocardial edema and scarring. Endomyocardial biopsy is reserved for selected cases to identify specific causes.

Treatment focuses on supportive care and treating the underlying cause. Standard heart failure therapies and antiarrhythmic measures are used as indicated. Activity is typically restricted during recovery. In severe cases, temporary circulatory support or heart transplantation may be required; immunosuppressive therapy is considered for definite autoimmune or specific etiologies.

Prognosis is variable. Many recover completely, especially with mild disease, but some patients progress to dilated cardiomyopathy or experience recurrent symptoms. Epidemiology suggests myocarditis is underdiagnosed, with higher observed rates in young adults after epidemics of viral illness.