Questions to Ask Your Doctor When Suspecting Myocarditis

Classified as a rare disease, myocarditis is misdiagnosed by physicians and is the 3rd leading cause of sudden death in young people. Most commonly caused by viral infections, myocarditis has also been reported to be caused by bacterial infections, cancer, toxins, and more. Myocarditis causes inflammation of the heart muscle. The inflammation can remain for a period of time after the infection has left the body, The area that was inflamed will develop a scar over the area, similar to the scar that develops when you get a cut. The area of the scar will decrease over time but will always remain as a scarred area. Even when the inflammation has subsided, the area of scar remains irritable for an undetermined period of time. This is why cardiologists recommend that a person not return to stressful exercise for a period of 3-6 months, on average, to allow the area to completely heal.

One of the reasons that myocarditis is underdiagnosed is because of its absence of symptoms specific to the disease. Some individuals may experience no symptoms at all. When the symptoms are present, they can be mistaken for other cardiac issues, respiratory or gastrointestinal illnesses. However, this disease is something that should be seriously considered if someone under 40 has unexplained cardiac difficulties, such as pain, shortness of breath, rapid heart rate, palpitations, lightheadedness, loss of consciousness especially during or after exercise, or when lying down.

While there is not a diagnostic test specific to myocarditis, there are tests that can be utilized to help in ruling it out depending on the symptoms. Common tests include blood tests for Troponins (proteins in the blood which are released when the heart muscle has been damaged), BNP (a blood test that measures levels of a protein that is made by your heart and blood vessels.) BNP levels are higher than normal when you have heart failure. Other tests can include an electrocardiogram, a chest X-ray, and echocardiogram, and sometimes an MRI scan. Occasionally a heart, or myocardial biopsy is required to confirm the diagnosis and determine the diagnosis, especially when thought to be Giant Cell Myocarditis.

Myocarditis is found most often in children and young adults between the ages of puberty and forty, with males being twice as likely as females to develop it. If you or a loved one are experiencing the symptoms of myocarditis, it is important to speak with your doctor urgently and ask if it is a possibility. It’s important to know the full scope of what can be done to diagnose myocarditis. Below is a list of symptoms and diagnostic tests that may help the doctors to rule out if you have myocarditis. Even with these tests, diagnosing myocarditis is still a very complex and difficult task.

Common Symptoms:

  • Shortness of breath, especially during or after exercise, or when lying down
  • Fatigue
  • Heart palpitations
  • Chest pain or pressure
  • Lightheadedness
  • Swelling in the hands, legs, ankles and feet
  • A sudden loss of consciousness

Who Is Affected?

Anyone, including otherwise healthy children and young adults. It is often caused by a viral infection, cancer, or other toxins.

What Can Diagnose Myocarditis?

  • Electrocardiogram
  • Echocardiogram
  • Chest X-ray
  • Heart Biopsy
  • MRI Scan
  • Blood tests

Questions to Ask Your Doctor

  • Could this be myocarditis?
  • As this fits the symptoms of myocarditis and it could be a possibility can I get an ECG?
  • Does my ECG show any anomalies whatsoever?
  • Can you please order a Troponin Level as well as a BNP to look for abnormalities?

Cardiac Biopsies are not a commonly ordered test and are very risky when done. Biopsies of the heart are only done at hospitals that perform transplants, so they are not a frequently ordered test. Plus, there is a high risk of false negative results if done for viral myocarditis. Speak with your doctor and make sure you are getting the best course of treatment for you.

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