Myocarditis

WHAT YOU SHOULD KNOW:

• Myocarditis (mi-o-kar-DI-tis) is an inflammation (swelling) of the myocardium (heart muscle). The myocardium pumps blood in and out of the heart and to other parts of the body. With myocarditis, the heart muscles are damaged and scars may form in them. This makes the heart weak and work harder to supply oxygen to the rest of your body. Over time, the increased pressure to pump blood may cause the heart to enlarge and become overworked. This may lead to heart failure and a decreased blood flow to the organs. Blood clots may develop and cause other life-threatening conditions, such as a stroke or heart attack. The most common cause of myocarditis is an infection caused by germs, especially viruses.
  
  
• Myocarditis may occur as an acute (sudden) or chronic (long term) heart problem. At the start of your disease, you may have fever, cough, or diarrhea (loose bowel movement). As your heart weakens and fails to pump, you may have chest pain or trouble breathing. Other symptoms include fatigue (tiredness), dizziness, fainting (passing out), or having too fast or irregular heartbeats. Myocarditis is diagnosed by blood tests, chest x-ray, biopsy, magnetic resonance imaging (MRI) scan, electrocardiogram (ECG), and echocardiography. Caregivers may suggest that you rest and limit physical activities so your heart will not work too hard.
  
  
• Treatment may include oxygen, medicines, such as antivirals or diuretics, cardiac devices, or implants, and surgery. With proper treatment, you have a greater chance of recovery and preventing further problems. Ask your caregiver for more information about these tests and treatments.

AFTER YOU LEAVE:

Take your medicine as directed.

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

• Aspirin to stop blood clots: Aspirin helps thin the blood to keep blood clots from forming. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead. Do not take more or less aspirin than directed. This medicine makes it more likely for you to bleed or bruise.
  
  
• Blood thinners: Blood thinners are medicines that help prevent blood clots from forming. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for you to bleed or bruise. If you are taking a blood thinner:
  
  
  • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin and a soft toothbrush on your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports, such as football.
    
    
  • Be aware of what medicines you take. Many medicines cannot be used when taking medicine to thin your blood. Tell your dentist and other caregivers that you take blood-thinning medicine. Wear or carry medical alert information that says you are taking this medicine.
    
    
  • Take this medicine exactly as your primary healthcare provider tells you. Tell him right away if you forget to take the medicine, or if you take too much. You may need to have regular blood tests while on this medicine. Your primary healthcare provider uses these tests to decide how much medicine is right for you.
    
    
  • Talk to your primary healthcare provider about your diet. This medicine works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and other foods, such as cooked peas and kiwifruit.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Activity:

• Limit your physical activity: Caregivers may suggest that you avoid doing stressful and heavy physical activities. Ask your caregivers what activities you are allowed to do.
  
  
• Rest: Rest when you feel it is needed. Slowly start to do more each day. Return to your daily activities as directed.

Good nutrition for your heart:

Get enough calories, protein, vitamins, and minerals to help prevent poor nutrition and muscle wasting. You may be told to eat foods low in cholesterol or sodium (salt). You also may be told to limit saturated and trans fats. Do eat foods that contain healthy fats, such as walnuts, salmon, and canola and soybean oils. Eat foods that help protect the heart, including plenty of fruits and vegetables, nuts, and sources of fiber. Ask what a healthy weight is for you. Set goals to reach and stay at that weight.

Lifestyle changes:

• Do not drink alcohol: Some people should not drink alcohol. These people include those with certain medical conditions or who take medicine that interacts with alcohol. Alcohol includes beer, wine, and liquor. Tell your caregiver if you drink alcohol. Ask him to help you stop drinking.
  
  
• Exercise: Exercise makes the heart stronger, lowers blood pressure, and helps keep you healthy. Begin to exercise slowly and do more as you get stronger. Talk with your primary healthcare provider before you start an exercise program.
  
  
• Do not smoke: If you smoke, it is never too late to quit. Ask for information about how to stop smoking if you need help.
  
  
• Manage your stress: Stress may slow healing and lead to illness. Learn ways to control stress, such as relaxation, deep breathing, and music. Talk to someone about things that upset you.

For more information:

Having myocarditis may be life-changing for you and your family. Accepting that you have myocarditis may be hard. You and those close to you may feel sad, angry, or frightened. These are normal feelings. Talk to your caregivers, family, or friends about your feelings. Contact the following for more information about myocarditis:

• American Academy of Family Physicians
  11400 Tomahawk Creek Parkway
  Leawood , KS 66211-2680
  Phone: 1- 913 - 906-6000
  Phone: 1- 800 - 274-2237
  Web Address: http://www.aafp.org
  

• National Heart, Lung and Blood Institute
  Health Information Center
  P.O. Box 30105
  Bethesda , MD 20824-0105
  Phone: 1- 301 - 592-8573
  Web Address: http://www.nhlbi.nih.gov/health/infoctr/index.htm
  

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• You have chills, a cough, or feel weak and achy.
  
  
• Your skin is itchy, swollen, or has a rash.
  
  
• You have questions or concerns about your heart condition, medicine, or care.

SEEK CARE IMMEDIATELY IF:

• Call 911 or an ambulance if you have any signs of a heart attack:
  
  
  • Discomfort in the center of your chest that feels like squeezing, pressure, fullness, or pain, that lasts for more than a few minutes or keeps returning
    
    
  • Discomfort or pain in your back, neck, jaw, stomach, or one or both of your arms
    
    
  • Feeling sick to your stomach
    
    
  • Having trouble breathing
    
    
  • A sudden cold sweat, particularly in combination with chest discomfort or trouble breathing
    
    
  • Feeling very lightheaded or dizzy, particularly in combination with chest discomfort or trouble breathing
  
  
• Your signs and symptoms come back or get worse.

Learn more about Myocarditis (Discharge Care)