After treatment, many patients live long, full lives free from the effects of myocarditis. For others, however, ongoing cardiovascular medication or even a heart transplant may be needed. Overall, dilated cardiomyopathy which can result from myocarditis accounts for up to 45 percent of heart transplants in the U.S. today.
I liken healing from myocarditis to healing from a broken bone. When you break a bone and are told by the doctor that it needs to be casted to allow it to heal properly, you don’t question them. You allow them to cast it and you just deal with the limitations it puts on you.
Sure, people’s bones can heal even if not casted, but they won’t probably heal as well nor work as well after it does eventually heal. The same goes for a healing heart that you stress by exercise.
You cannot place your heart in a cast to allow it to rest and heal itself. Your heart needs to continue to work and pump blood throughout your body so that you can continue to live. The only true treatment for everyone affected by myocarditis is Cardiac Rest. Cardiac Rest is not making the heart work harder than it needs to (by keeping the heart rate within the normal range of 60-100 beats per minute) which allows the heart to heal the best that it can. Sometimes there are other symptoms that may need to be taken care of (i.e. elevated blood pressure, frequent palpitations, heart failure, etc.…), but most people only require cardiac rest.
Unfortunately, most of the people who develop myocarditis are young, athletic, and otherwise healthy individuals. When they start to “feel better”, they think that they can resume exercising to overall get “stronger again”. They do not realize that it takes 3-6 months for the heart to heal itself after developing myocarditis. Just like it usually takes 8 weeks for a bone in a cast to heal, 3-6 months is the time the heart needs to heal since it still must work while it is healing itself.
Trust me, I have spoken to so many patients who tell me that even though they are feeling better, every time they try and exercise, the pain in their chest comes back or they have more palpitations, and in general feel worse again. Please listen to the experts who have determined that 3-6 months is the usual time frame that a heart needs to heal itself. Sometimes it may take longer, depending on the severity of the case of myocarditis that you have.
Cardiac rest means: no exercise (light walking, is usually permitted, but you need to clear that through your cardiologist), not speed walking, distance walking, running, or jogging, no lifting weights, energy drinks, caffeine, smoking, recreational drugs, anything that can increase the heart rate and make the heart work harder.
The area of the heart muscle affected by the myocarditis remains irritable to stimulation during this 3-6 month period and a person is more prone to developing lethal cardiac arrythmias during this time as well as the possibility of the heart enlarging (cardiomyopathy) to try and accomplish what you are asking of it to do, pump more blood and work harder while it is sick and trying to recover..
Healthy lifestyle changes can also support proper heart function. Eating fresh fruits and vegetables and healthy options for protein. Your doctor may recommend that you reduce sodium in your diet, avoid alcohol, limit fluid intake and quit smoking.
Giving up the exercise to allow the heart to heal the best that it can, will benefit you down the line. The thought of living with an enlarged heart and heart failure is worse than giving up the 3-6 months needed to best allow the heart to heal. Your doctor can clear you for increasing exercise again by conducting a few tests to see how your heart responds to the stress of exercise after this period of cardiac rest.
Genevieve Rumore, RN, BSN
Executive Director
Myocarditis Foundation
