Mursa Images/Getty Images
Symptoms of Myocarditis
The degree of symptoms tends to correlate with the severity of inflammation present in the heart muscle. Mild symptoms are associated with milder cases of myocarditis, while severe symptoms usually reflect a significant inflammatory process.
In more significant cases actual cardiac symptoms appear, including chest pain. If the myocarditis becomes severe enough to cause heart failure,dyspnea(shortness of breath) andedema(swelling) of the legs and feet can occur, along with all the other problems one can experience withheart failure.
1:45Click Play to Learn All About Myocarditis
1:45
Click Play to Learn All About Myocarditis
Occasionally myocarditis overwhelms the heart and produces rapid, severe, and irreversible heart failure.
Heartarrhythmiascan occur during acute myocarditis.These arrhythmias can be of almost any type, including both thebradycardias(slow heart rhythms) andtachycardias(rapid heart rhythms), such asatrial fibrillationand ventricular tachycardia. These arrhythmias usually disappear once the acute myocarditis resolves.
What Causes Myocarditis?
Many causes of myocarditis have been identified. These include:
Myocarditis and Covid-19
Since the start of the COVID-19 pandemic, researchers have published several studies on the connection between the virus and myocarditis.
One study found that between 2.4 and 4.1 out of 1,000 patients hospitalized for COVID-19 developed acute myocarditis, usually in the absence of pneumonia.
There has also been some research on the risk of myocarditis in those who received COVID vaccines. According to a July 2021 study, myocarditis was reported at a higher rate than expected among some people who received the Pfizer or Moderna vaccines. Most of the suspected cases developed after the second dose and were among males between 12 and 39 years old. Despite these cases, the study concluded that the benefits of the COVID-19 vaccine outweigh the rare risk of myocarditis.
Pericarditis and Long COVID Effects on Heart
How Is Myocarditis Diagnosed?
The diagnosis of myocarditis takes into account the patient’s symptoms and physical exam. Other tests include:
Occasionally, a heart muscle biopsy is required to document the extent and type of inflammation present in the heart muscle.
How Is Myocarditis Treated?
The treatment of myocarditis is aimed first and foremost at identifying and treating the underlying cause.
For instance, it is critical to treat an underlying infection with the appropriate antibiotics, to aggressively treat an underlying autoimmune disorder, or to remove the source of toxin exposure (such as cocaine or alcohol).
If heart failure is present, aggressivetreatment for heart failureconsisting of some of the following medications may be used:
In addition, people with acute myocarditis should avoidexerciseor any unnecessary physical exertion to reduce the work of the heart during this acute phase.
With aggressive treatment, many people with myocarditis will recover completely. In some people, however, the recovery is not complete, and some degree of cardiac damage may be permanent. In addition, inflammation may smolder along for months or years, causing gradual worsening of cardiac function.
For this reason, anyone who has had myocarditis needs to be reevaluated every few months, and their physical activity may need to be limited until it is clear that the problem has fully resolved. Even at that point, people who have had myocarditis should be reexamined on an annual basis.
Summary
In most cases, myocarditis is a relatively mild and self-limited heart problem. But in some people, myocarditis can lead to significant heart failure, and it can do so either acutely or more gradually. With an accurate diagnosis, myocarditis can be treated to avoid serious complications.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Heart Association.Myocarditis.Johns Hopkins Medicine.Myocarditis.Ammirati E, Lupi L, Palazzini M, et.al.Prevalence, characteristics, and outcomes of COVID-19-associated acute myocarditis.Circulation. 2022 Apr 12;145(15):1123-1139. doi:10.1161/CIRCULATIONAHA.121.056817Oster ME, Shay DK, Su JR, et al.Myocarditis cases reported after mRNA-based COVID-19 vaccination in the US from December 2020 to August 2021.JAMA.2022;327(4):331–340. doi:10.1001/jama.2021.24110Additional ReadingAmmirati E, Cipriani M, Moro C, et al. Clinical Presentation and Outcome in a Contemporary Cohort of Patients With Acute Myocarditis. Circulation 2018; 138:1088.Caforio AL, Pankuweit S, Arbustini E, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2013; 34:2636.Maron BJ, Udelson JE, Bonow RO, et al. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 3: Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Cardiomyopathy and Other Cardiomyopathies, and Myocarditis: A Scientific Statement From the American Heart Association and American College of Cardiology. Circulation 2015; 132:e273.
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Heart Association.Myocarditis.Johns Hopkins Medicine.Myocarditis.Ammirati E, Lupi L, Palazzini M, et.al.Prevalence, characteristics, and outcomes of COVID-19-associated acute myocarditis.Circulation. 2022 Apr 12;145(15):1123-1139. doi:10.1161/CIRCULATIONAHA.121.056817Oster ME, Shay DK, Su JR, et al.Myocarditis cases reported after mRNA-based COVID-19 vaccination in the US from December 2020 to August 2021.JAMA.2022;327(4):331–340. doi:10.1001/jama.2021.24110Additional ReadingAmmirati E, Cipriani M, Moro C, et al. Clinical Presentation and Outcome in a Contemporary Cohort of Patients With Acute Myocarditis. Circulation 2018; 138:1088.Caforio AL, Pankuweit S, Arbustini E, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2013; 34:2636.Maron BJ, Udelson JE, Bonow RO, et al. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 3: Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Cardiomyopathy and Other Cardiomyopathies, and Myocarditis: A Scientific Statement From the American Heart Association and American College of Cardiology. Circulation 2015; 132:e273.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Heart Association.Myocarditis.Johns Hopkins Medicine.Myocarditis.Ammirati E, Lupi L, Palazzini M, et.al.Prevalence, characteristics, and outcomes of COVID-19-associated acute myocarditis.Circulation. 2022 Apr 12;145(15):1123-1139. doi:10.1161/CIRCULATIONAHA.121.056817Oster ME, Shay DK, Su JR, et al.Myocarditis cases reported after mRNA-based COVID-19 vaccination in the US from December 2020 to August 2021.JAMA.2022;327(4):331–340. doi:10.1001/jama.2021.24110
American Heart Association.Myocarditis.
Johns Hopkins Medicine.Myocarditis.
Ammirati E, Lupi L, Palazzini M, et.al.Prevalence, characteristics, and outcomes of COVID-19-associated acute myocarditis.Circulation. 2022 Apr 12;145(15):1123-1139. doi:10.1161/CIRCULATIONAHA.121.056817
Oster ME, Shay DK, Su JR, et al.Myocarditis cases reported after mRNA-based COVID-19 vaccination in the US from December 2020 to August 2021.JAMA.2022;327(4):331–340. doi:10.1001/jama.2021.24110
Ammirati E, Cipriani M, Moro C, et al. Clinical Presentation and Outcome in a Contemporary Cohort of Patients With Acute Myocarditis. Circulation 2018; 138:1088.Caforio AL, Pankuweit S, Arbustini E, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2013; 34:2636.Maron BJ, Udelson JE, Bonow RO, et al. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 3: Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Cardiomyopathy and Other Cardiomyopathies, and Myocarditis: A Scientific Statement From the American Heart Association and American College of Cardiology. Circulation 2015; 132:e273.
Ammirati E, Cipriani M, Moro C, et al. Clinical Presentation and Outcome in a Contemporary Cohort of Patients With Acute Myocarditis. Circulation 2018; 138:1088.
Caforio AL, Pankuweit S, Arbustini E, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2013; 34:2636.
Maron BJ, Udelson JE, Bonow RO, et al. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 3: Hypertrophic Cardiomyopathy, Arrhythmogenic Right Ventricular Cardiomyopathy and Other Cardiomyopathies, and Myocarditis: A Scientific Statement From the American Heart Association and American College of Cardiology. Circulation 2015; 132:e273.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
