Diagnosis

Early diagnosis of myocarditis is important to preventing long-term heart damage. To diagnose myocarditis, a healthcare professional examines you and listens to your heart with a stethoscope.

Blood and imaging tests may be done to check your heart health. Imaging tests can help confirm myocarditis and determine its severity.

Tests

Tests to diagnose myocarditis include:

  • Blood tests. Blood tests are usually done to check for a heart attack, inflammation and infection. A cardiac enzyme test can check for proteins related to heart muscle damage. Antibody blood tests may help learn if you had an infection linked to myocarditis.
  • Electrocardiogram (ECG or EKG). This quick and painless test shows how the heart is beating. Your healthcare professional can look for signal patterns on an ECG to learn if you have irregular heartbeats.
  • Chest X-ray. A chest X-ray shows the size and shape of the heart and lungs. A chest X-ray can tell if there's fluid in or around the heart that might be related to heart failure.
  • Heart MRI, also called a cardiac MRI. This test uses magnetic fields and radio waves to create detailed images of the heart. A cardiac MRI shows the heart's size, shape and structure. It can help diagnose myocarditis.
  • Echocardiogram. Sound waves create moving images of the beating heart. An echocardiogram can show the heart's size and how well blood flows through the heart and heart valves. An echocardiogram can see if there's fluid around the heart.
  • Cardiac catheterization and heart muscle biopsy. A doctor places a thin, flexible tube called a catheter into a blood vessel in the arm or groin. It's guided to an artery in the heart. Dye flows through the catheter to help the heart arteries show up more clearly on X-rays. A tiny sample of heart muscle tissue may be taken during this test. This is called a biopsy. The sample is sent to a lab to be checked for signs of myocarditis or an infection.

Treatment

Often, myocarditis gets better on its own or with treatment. Myocarditis treatment focuses on the cause and the symptoms, such as heart failure.

Myocarditis treatment may include:

  • Medicine.
  • Medical devices.
  • Surgery.

Medications

People with mild myocarditis may only need rest and medicine. If myocarditis is severe, medicines may be given through an IV at a hospital to quickly improve the heart's ability to pump blood.

Medicine to treat myocarditis may include:

  • Corticosteroids. These medicines may be used to treat some rare types of viral myocarditis, such as giant cell and eosinophilic myocarditis.
  • Medicines to prevent blood clots. If myocarditis is causing severe heart failure or irregular heartbeats, medicine may be given to reduce the risk of blood clots in the heart.
  • Heart medicines. Medicines may be used to remove extra fluid from the body and reduce the strain on the heart. Some types of medicines that may be used to treat myocarditis symptoms are diuretics, beta blockers, angiotensin-converting enzyme (ACE) inhibitors or angiotensin 2 receptor blockers (ARBs).
  • Medicines to treat chronic conditions. Sometimes another health condition, such as lupus, causes myocarditis. Treating this underlying condition may help reduce heart muscle inflammation.

Some people with myocarditis take medicines for just a few months and then get better completely. Others may have long-term heart damage that needs lifelong medicine. It's important to have regular health checkups after myocarditis to check for possible complications.

Therapies

A treatment called extracorporeal membrane oxygenation (ECMO) may be used to help the heart to recover or while waiting for other treatments, such as a heart transplant.

An ECMO machine works like the lungs. It removes carbon dioxide and adds oxygen to the blood. If you have severe heart failure, this device can send oxygen to your body. During ECMO, blood is removed from the body through tubes, passed through the machine and then returned to the body.

Surgeries and procedures

Severe myocarditis needs aggressive treatment. Treatment may include:

  • Ventricular assist device (VAD). A VAD helps pump blood from the lower chambers of the heart to the rest of the body. It's a treatment for a weakened heart or heart failure. Open-heart surgery is usually needed to place the device in the body. The device may be used to help the heart work while waiting for other treatments, such as a heart transplant.
  • Intra-aortic balloon pump (IABP). This device helps increase blood flow and reduce the strain on the heart. It's placed in the body's main artery, called the aorta. A doctor inserts a thin tube called a catheter into a blood vessel in the leg and guides it to the aorta. A balloon attached to the end of the catheter inflates and deflates as the heart beats and relaxes.
  • Heart transplant. An urgent heart transplant may be needed for those who have very severe myocarditis.

Lifestyle and home remedies

Rest and reducing the strain on the heart are important parts of myocarditis recovery.

If you have or had myocarditis, ask your healthcare professional which type and amount of physical activity is safe for you. If you have myocarditis, you should avoid competitive sports for at least 3 to 6 months.

Preparing for your appointment

If you have symptoms of myocarditis, make an appointment for a health checkup. If symptoms are severe, you may first be seen in an emergency setting. You usually are sent to a doctor trained in heart diseases, called a cardiologist. You also may see a doctor trained in infectious disease.

What you can do

Here's some information to help you get ready for your appointment. Write down the following details:

  • Your symptoms, including any that might seem unrelated to myocarditis, and when they began.
  • Important personal information, including recent illnesses and any symptoms, recent travel locations, and your and your family's medical history.
  • All medicines, vitamins and supplements you take. Include those bought without a prescription. Also include the doses.
  • Questions to ask your healthcare team.

For myocarditis, basic questions to ask your healthcare team include:

  • What's the most likely cause of my symptoms?
  • What are other possible causes?
  • What tests do I need?
  • How is myocarditis treated?
  • What side effects can I expect from treatment?
  • Are there alternatives to the primary treatment that you're suggesting?
  • I have other health conditions. How can I best manage these conditions together?
  • Do I need to change my activities or diet?
  • Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions. Take a family member or friend along to your appointment, if possible, to help you remember the information you receive.

What to expect from your doctor

Your healthcare team is likely to ask many questions, including:

  • Have you recently been sick or have you recovered from another illness?
  • Have you recently traveled out of the country?
  • What, if anything, makes symptoms better?
  • What, if anything, makes your symptoms worse?
By Mayo Clinic Staff