Discover Myocarditis Causes, Symptoms, Diagnosis and Treatment

About Myocarditis

Myocarditis is a illness marked by inflammation and blinking of the heart muscle. Although the exact incidence of myocarditis is not known, it is estimated that several thousand patients per year are diagnosed in the United States. Myocarditis usually attacks otherwise healthy people. It is believed that 5 to 20% of all cases of unexpected death in young adults are due to myocarditis.
There are many causes of myocarditis, including viral infections, autoimmune diseases, environmental toxins, and adverse reactions to medications. The prognosis is changeable but chronic heart failure is the major long term complication. Myocarditis and the related disease of idiopathic dilated cardiomyopathy are the cause of concerning 45% of heart transplants in the United States.

Implantable Defibrillators: New Hope for Heart Failure Patients

An implantable cardiac defibrillator (ICD) is a small, battery-
powered device that uses an electric signal to automatically
correct an abnormal heartbeat. Implanted beneath the skin of
the chest, ICDs have been used during the past decade to treat
life-threatening arrhythmias. Now, new research suggests that an
implantable defibrillator can help to extend the lives of people
with heart failure.

About 50 percent of deaths in heart failure are sudden deaths
that are probably due to an abnormally fast heartbeat in one of
the heart’s lower chambers. In a large study of patients with
moderate to severe heart failure, one-third of participants were
treated with an implantable defibrillator, while one-third took
the anti-arrhythmia drug amiodarone (sold as Cordarone or
Pacerone), and another one-third received neither treatment.
The results: ICD treatment significantly reduced deaths over the
                        next 4 years, while the medication did
                           not. The benefit from ICD therapy
                            appeared to be strongest among
                            those with moderate heart failure.

  Getting Help for a

     Heart Attack

     For many people, the first symptom of heart disease is a heart

     attack. That means everyone should know how to identify the

     symptoms of a heart attack and how to get immediate medical help.

     Ideally, treatment should start within 1 hour of the first symptoms.

     Recognizing the warning signs and getting help quickly can save

     your life.

     Know the Warning Signs

     Not all heart attacks begin with sudden, crushing pain, as is often

     shown on TV or in the movies. Many heart attacks start slowly

     with mild pain or discomfort. The most common warning signs are:

       ¦   Chest discomfort. Most heart attacks involve discomfort in the

           center of the chest that lasts for more than a few minutes.

           It may feel like uncomfortable pressure, squeezing, fullness, or

           pain. The discomfort can be mild or severe, and it may come

           and go.

       ¦   Discomfort in other areas of the upper body, including one or

           both arms, the back, neck, jaw, or stomach.

       ¦   Shortness of breath. This symptom may occur with or without

           chest discomfort.

       ¦   Other signs include nausea, light-headedness, or breaking out in

           a cold sweat.

     Get Help Quickly

     If you think that you or someone else may be having a heart attack,

     you must act quickly to prevent disability or death, and to get the

     most benefit from current treatments. Wait no more than a few

     minutes—5 at most—before calling 9–1–1.

     It is important to call 9–1–1 because emergency medical personnel

     can begin treatment even before you get to the hospital. They also

     have the equipment and training to start your heart beating again if

     it stops. Calling 9–1–1 quickly can save your life.

Even if you’re not sure you’re having a heart attack, call 9–1–1 if your

     symptoms last up to 5 minutes. If your symptoms stop completely in

     less than 5 minutes, you should still call your doctor right away.

     You must also act at once because hospitals have clot-dissolving

     medicines and other artery-opening treatments that can stop a heart

     attack if given quickly. These treatments work best when given

     within the first hour after a heart attack starts.

     When you get to the hospital, don’t be afraid to speak up for what

     you need—or bring someone who can speak up for you. Ask for

     tests that can determine if you are having a heart attack. Commonly

     given initial tests include an electrocardiogram (EKG or ECG) and a

     cardiac blood test (to check for heart damage). You have the right

     to be thoroughly examined for a possible heart attack. If you are

     having a heart attack, you have the right to immediate treatment to

     help stop the attack.

 Delay Can

                         Be Deadly

  Most people who have a heart attack wait too long to seek medical

  help—and that can be a fatal mistake. Some delay because they

  don’t understand the symptoms of a heart attack and think that

  what they’re feeling is due to something else. Others put off getting

  help because they don’t want to worry others or “cause a scene,”

  especially if their symptoms turn out to be a false alarm. Women

  are especially likely to delay. A large study of heart attack patients

  found that, on average, women waited 22 minutes longer than men

  did before going to the hospital.

  Don’t wait. When you’re facing something as serious as a possible

  heart attack, it’s much better to be safe than sorry. Waiting too long

  can cause permanent disability or death. If you have any symptoms

  of a possible heart attack that last up to 5 minutes, call 9–1–1

  right away.

Recovering Well:

Life After a Heart Attack

or Heart Procedure

Having a heart attack or a heart procedure can be a frightening and

upsetting experience. It is difficult to discover—often suddenly—

that your body isn’t working the way it should, and to be plunged

into an unfamiliar world of hospitals and high-tech procedures. But

it’s important to know that millions of people have survived a heart

attack, recovered fully, and gone on to resume active, normal lives.

Likewise, most people who undergo heart surgery recover well and

return to their usual activities. Many surgery patients eventually feel

healthier than they did before their procedure.

The time it takes to get back

to normal will depend on

many factors, including your

age and general health.

If you have had a heart

attack, the pace of recov-

ery will also depend on

the severity of the attack.

If you have undergone

surgery, recovery time will

depend partly on the type

of procedure you had.

But whatever your

situation, there

is much you

can do to

improve your health and prevent complications following a heart

     attack or major heart procedure.

     The first step: Give yourself permission to recover. You and your body

     have been through a lot, and it will take some time to feel like yourself

     again. Expect to feel quite tired at first, and to gradually regain your

     s t rength and energy. While individual needs vary, following are some

     overall tips for recovering well from a heart attack or heart surgery.

     Your First Weeks at Home

     When you first arrive home from the hospital, you’ll need to get a

     lot of rest so that your heart can begin to heal. It is very important

     to eat healthfully and to get enough sleep. Take the medications

     your doctor has prescribed for you. (See “Heart-Healing Medicines”

     on the next page.) Avoid heavy yard work, house cleaning, or other

     projects that require a lot of energy. Also refrain from physical

     activity in very hot or cold weather. Ask family and friends to help

     out with chores, childcare, and other activities that may be difficult

     to take care of during your first weeks at home.

     At the same time, it is important to get up and move around as you

     begin to recover. Your heart is a muscle that needs be exercised—

     though very gently at first. Pace yourself. Allow plenty of time for

     each thing you do during the day, from getting out of bed to taking

     a shower to preparing a simple breakfast. Rest between activities,

     and whenever you feel tired. Ask your doctor for a list of guidelines

     for activity during your first few weeks at home.

     Your doctor will want to check your progress 1 to 4 weeks after you

     leave the hospital. During your first followup visit, your doctor will

     check your weight and blood pressure, make any needed changes in

     your medicines, perform necessary tests, and check how your recov-

     ery is progressing overall. Use this opportunity to ask any questions

     you may have about safe or unsafe activities, medicines, lifestyle

     changes, or any other issues that concern you. You may want to

     write down your questions beforehand.

     For some situations and questions, it is best to call your doctor right

     away rather than wait for your next appointment. 

Getting Tested for Heart Disease

You may be reading this book because you think you might have heart disease but aren’t yet sure. Keep in mind that heart disease doesn’t always announce itself with symptoms. That means you could have heart disease and still feel perfectly fine. The best course is to talk with your doctor about your personal degree of heart disease risk and about whether getting tested is a good idea.

Most screening tests for heart disease are done outside of the body and are painless. After taking a careful medical history and doing a physical examination, your doctor may give you one or more of the following tests:

Electrocardiogram (ECG or EKG) makes a graph of the heart’s electrical activity as it beats. This test can show abnormal heartbeats, heart muscle damage, blood flow problems in the coronary arteries, and heart enlargement.

Stress test (or treadmill test or exercise ECG) re c o rds the heart ’s electrical activity during exercise, usually on a treadmill or exercise bike. If you are unable to exercise due to arthritis or another health condition, a stress test can be done without exercise . Instead, you can take a medicine that increases blood flow to the h e a rt muscle and shows whether there are any problems in that flow.

Nuclear scan (or thallium stress test) shows the working of the heart muscle as blood flows through the heart . A small amount of radioactive material is injected into a vein, usually in the arm, and a camera records how much is taken up by the heart muscle.

Echocardiographic changes sound waves into pictures that show the heart’s size, shape, and movement. The sound waves also can be u s e d to see how much blood is pumped out by the heart when it contracts.

Coronary angiography (or angiogram or arteriography) shows an x ray of blood flow problems and blockages in the coronary arteries. A thin, flexible tube called a catheter is threaded through an artery of an arm or leg up into the heart. A dye is then injected into the tube, allowing the heart and blood vessels to be filmed as the heart pumps. The picture is called an angiogram or arteriogram.

Ventriculogram is frequently a part of the x-ray dye test described before. It is used to get a picture of the heart’s main pumping chamber, typically the left ventricle.

Intracoronary ultrasound uses a catheter that measures blood flow. It creates a picture of the coronary arteries that shows the thickness and other features of the artery wall. This lets the doctor see blood flow and any blockages.

In addition, several new, highly sensitive screening tests have been developed. Ask your doctor about these tests:

Carotid doppler ultrasound uses sound waves to detect blockages and narrowing of the carotid artery in the neck, both of which can signal an increased risk for heart attack or stroke.

Electron-beam computed tomography is a superfast scan that provides a snapshot of the calcium buildup in your coronary arteries.

Heart Disease A Wakeup Call

If you have heart disease, you may understandably hope that it’s only a temporary ailment, one that can be cured with medicine or surgery. But heart disease is a lifelong condition: Once you have it, you’ll always have it. It’s true that procedures such as angioplasty and bypass surgery can help blood and oxygen flow more easily through the coronary arteries that lead to the heart. But the arteries remain damaged, which means that you’re more likely to have a heart attack. It is sobering, yet important, to realize that the condition of your blood vessels will steadily worsen unless you make changes in your daily habits. Many people die of complications from heart disease, or become permanently disabled. That’s why it is so vital to take action to control this serious condition.


The good news is that you can control heart disease. There is much you can do to manage your heart condition, reduce your risk of a first or repeat heart attack, and improve your chances of living a long, rewarding life. The sooner you get started, the better your chances of avoiding further heart problems, feeling better, and staying well. So use this handbook to find out more about your own heart condition and what you can do to improve it. You have the power to make a positive difference in your heart health—and you can start making that difference today.

What Is Heart Disease?

Coronary heart disease is the main form of heart disease. It occurs when the coronary arteries, which supply blood to the heart muscle, become hardened and narrowed due to a buildup of plaque on the arteries’ inner walls. Plaque is the accumulation of cholesterol, fat, and other substances. As plaque continues to build up in the arteries, blood flow to the heart is reduced.

Coronary heart disease—often simply called heart disease—can lead to a heart attack. A heart attack happens when a cholesterol-rich plaque bursts and releases its contents into the bloodstream. This causes a blood clot to form over the plaque, totally blocking blood flow through the artery and preventing vital oxygen and nutrients from getting to the heart. A heart attack can cause permanent damage to the heart muscle.

Heart disease includes a number of other serious conditions, including: 

Angina. More than 6 million Americans live with angina, which is chest pain or discomfort that occurs when the heart muscle is not getting enough blood. The inadequate blood flow is caused by narrowed coronary arteries, due to an accumulation of plaque. A bout of angina is not a heart attack, but it means that you’re more likely to have a heart attack than someone who doesn’t have angina. There are two kinds of angina:

Stable angina has a recognizable pattern. It may feel like pressure or a squeezing pain in your chest. The pain may also occur in your shoulders, arms, neck, jaw, or back. It may also feel like indigestion. Stable angina pain is generally brought on by some kind of exertion or strain (such as climbing stairs or experiencing emotional stress), and it is usually relieved by rest or medicine.

Unstable angina is more serious than stable angina. Occurring at any time, unstable angina often reflects a change in a previously stable pattern of angina. Episodes of unstable angina are usually more f requent, painful, and longer lasting than bouts of stable angina, and a re less often relieved by rest or medicine. Unstable angina is a sign that you may have a heart attack very soon. The symptoms are the same as if you are having a heart attack. (See page 46 for heart attack warning signs.) If you have any of these symptoms, you should call 9–1–1 right away so that you can get immediate treatment.

Congestive heart failure. Congestive heart failure is a life-threatening condition in which the heart cannot pump enough blood to supply the body’s needs. Affecting nearly 5 million Americans, heart failure occurs when excess fluid collects in the body as a result of heart weakness or injury. This condition leads to a buildup of fluid in the lungs, causing swelling of the feet, tiredness, weakness, and breathing difficulties.

High blood pressure is the leading cause of congestive heart failure in the United States. Heart disease and diabetes are also major underlying causes of heart failure. People who have had a heart attack are at high risk of developing this condition.

 Arrhythmias are problems that affect the electrical system of the heart muscle, producing abnormal heart arrhythmias . Many factors can contribute to arrh y t hm i a s , including heart disease, high blood pre s s u re, diabetes , smoking, heavy alcohol use, an electrolyte imbalance, drug abuse, and stress ..