What is acute myocarditis? Acute myocarditis, as its name implies, is inflammation of myocardium. The most common cause of inflammation is virus infection, including Coxsackie B virus, echovirus and adenovirus. In addition to infection, other inflammatory diseases, such as rheumatic fever or Kawasaki disease, autoimmune diseases or some poisons or drugs may also cause acute myocarditis.
The disease can occur at all ages, and young people under 40 are at high risk, including newborns. However, myocarditis in infancy is mostly acute attack and even violent death. Older children or adolescents have a slow onset, but may develop congestive heart failure or dilated cardiomyopathy. During 1998, many sick children died of heart failure caused by acute myocarditis.
The initial symptoms of acute myocarditis are very similar to colds, and the clinical manifestations of acute myocarditis are ever-changing. Early symptoms include cold, fever, diarrhea, shortness of breath, pallor, chest pain, and even shock in severe cases. It is often misdiagnosed as upper respiratory tract infection or gastrointestinal cold, but the condition develops rapidly. Often symptoms appear 1 day to a few days, and the condition will deteriorate rapidly. If you use chest X-rays, you can often see enlargement of the heart and pulmonary edema. Electrocardiogram may show tachycardia or bradycardia or even conduction interruption, myocardial hypoxia, arrhythmia or abnormal conduction.
The mortality rate of acute myocarditis is often higher than that of chronic failure caused by general heart disease. According to Huang Qinan, a pediatrician at National Taiwan University Hospital, the mortality rate of acute myocarditis with obvious symptoms can reach 22%, and the mortality rate of explosive acute myocarditis can even reach 50% to 70%.
How to treat acute myocarditis and its prognosis To treat acute myocarditis, in addition to bed rest to reduce the burden on the heart, patients often need diuretics, cardiotonic agents or antiarrhythmic drugs for adjuvant treatment, and intravenous immunoglobulin C (IVIG) may be helpful. The nursing of acute myocarditis needs the cooperation of cardiologists and intensive care teams. Some patients with severe explosive myocarditis even need cardiopulmonary bypass, that is, extracorporeal membrane oxygenator (commonly known as Yekman extracorporeal membrane oxygenation) or heart transplantation. Patients who have recovered need long-term follow-up, because the heart after myocarditis may produce dilated cardiomyopathy in the future.
To treat acute myocarditis, the most important thing is to grasp the golden opportunity to avoid worsening into explosive myocarditis. Once you have cold symptoms, you should seek medical attention immediately to avoid delaying treatment.