People may feel feverish and have generalised aches and pains
as with any other viral illness. When the heart is severely affected a person
may feel tired and breathless. Chest pain and palpitations are relatively common
under these circumstances. Apart from a rapid heart rate, the doctor may not
find any other abnormalities if there is only mild myocarditis. However, if it
is severe there may be evidence of heart failure and/or arrhythmia.
The presence of a flu-like illness and fever may raise the
suspicion of myocarditis in someone with symptoms. Simple blood tests may,
however, show signs of inflammation and heart damage. The
ECG may show
changes which can come and go, are non-specific and can occur in other heart
diseases. An ECHO
can show an enlarged heart, which pumps poorly. The diagnosis can be confirmed
by a biopsy (a small sample) taken from the heart. An
MRI scan can be
useful for diagnosing inflamed heart muscle.
In very mild cases, both the ECG and the ECHO may be
normal, so when symptoms of a flu-like illness are present, a person should be
cautious and not take part in any exercise or sports until they have recovered
fully.
Patients should rest until symptoms settle. Patients with
heart failure and arrhythmia must stay in hospital for treatment of these (see
the section on
dilated
cardiomyopathy). Steroids may be used in specific forms of myocarditis.
Patients should not take part in any exercise or sports until all symptoms have
settled and the ECG and ECHO are back to normal. Over three quarters of people
will improve within two weeks without any complications. Around 1 in 10 patients
may then develop dilated cardiomyopathy and require lifelong treatment for heart
failure.
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