How to Distinguish Myocarditis from Other Heart Conditions

Female Doctor Listens To Patient’s HeartIt can be scary to be diagnosed with any type of heart condition, but with assistance from the Myocarditis Foundation, you can access information about being diagnosed with myocarditis and resources to support you through your journey. We are passionate about providing awareness, research, and support for people affected with myocarditis to save more lives. Here, we share insights on how to differentiate myocarditis from other heart conditions with similar symptoms.

Considering the Symptoms

Myocarditis can present without what a person would think of as “cardiac symptoms”.  It may look like viral type symptoms, such as the flu or gastroenteritis; no symptoms; or chest pain and shortness of breath. It’s still important to weigh the symptoms the patient is experiencing with those of other heart conditions to distinguish them.

For example, myocarditis and heart conditions like heart failure share many symptoms, such as fatigue, shortness of breath, exercise intolerance, and difficulty breathing while lying down. Another example is that often myocarditis symptoms resemble those of a heart attack: chest pain and fatigue. However, there is a way to distinguish them, as with myocarditis, the coronary vasculature that supplies the heart usually appears normal, while with a heart attack it would generally be blocked. If a patient presents with a sudden onset of cardiac symptoms like chest pain or arrhythmia, and there is no evidence for other disorders, myocarditis should be suspected.

One symptom that separates myocarditis from other heart conditions is that it usually appears after an upper respiratory or gastrointestinal infection or virus, unlike a congenital or common heart condition.

Evaluating with Labs and Scans

Although there are no specific noninvasive tests to diagnose myocarditis, cardiologists often use blood work, ECGs, and imaging scans to confirm the suspected diagnosis as they can provide more in-depth information and images of the heart. These labs and scans include:

  • Bloodwork, which can show an elevation in troponin, which indicates heart muscle damage
  • Electrocardiograms (ECG or EKG), which measures your heart’s electrical signal to show how well it is working and can detect irregular heartbeats common with myocarditis
  • Echocardiograph, which can show your heart size, heart wall motion abnormalities, and fluid build-up around the heart
  • Chest X-ray, which can show the heart’s size and shape, as well as fluid in or around the heart that might be related to heart failure from myocarditis
  • Cardiac magnetic resonance imaging (MRI), which can show characteristic features with signs of inflammation that support the diagnosis

These processes are often used to diagnose mild cases of myocarditis. However, the specific tests and labs used will depend on the symptoms and severity of the illness.

Utilizing a Biopsy

A cardiac biopsy may be required to confirm the diagnosis and guide therapy in more severe cases or if patients do not respond to normal medical care. This is when your doctor removes a small sample of heart muscle tissue to analyze for inflammation or infection that can be caused by certain types of myocarditis, like giant cell myocarditis. Biopsies of the heart should only be done when the results will have a significant influence on prognosis or treatment. To reduce the risk of procedure-related problems, heart biopsies should be performed by doctors with extensive experience in the technique.

For more information, contact Myocarditis Foundation today.