How to diagnose myocarditis
Apr 24, 2023
Source: Cainiu Health
Dr. Tian Hongbo
Introduction
Myocarditis includes viral myocarditis and fulminant myocarditis. The diagnosis of viral myocarditis involves medical history and clinical signs, cardiac-related abnormalities, and indicators of myocardial injury. Fulminant myocarditis is diagnosed when the condition develops rapidly, leading to severe circulatory compromise in a short period of time, with tests revealing ventricular damage or impaired ventricular function.
Generally, myocarditis includes viral myocarditis and fulminant myocarditis, and the diagnostic criteria vary depending on the type. The diagnosis of viral myocarditis relies on medical history, physical signs, and relevant examination results, while the diagnosis of fulminant myocarditis is also based on symptoms and test findings. The details are as follows:
I. Viral Myocarditis
1. Medical History and Physical Signs
Within 3 weeks prior, there has been a history of viral infections such as upper respiratory tract infection or diarrhea. Patients may experience cardiac discomfort symptoms including fatigue, chest tightness, and dizziness. On examination, arrhythmias may be detected, such as gallop rhythm, pericardial friction rub, or diminished heart sounds.
2. Cardiac Abnormalities
Cardiac abnormalities appear within 3 weeks after viral infection, such as sinus tachycardia, ventricular premature beats, abnormal Q waves on electrocardiogram (ECG), or abnormal ST-segment elevation.
II. Fulminant Myocarditis
This condition progresses rapidly, leading to severe circulatory compromise in a short time, such as syncope, shock, or sudden death. Laboratory tests reveal significant myocardial damage. A diagnosis of fulminant myocarditis can be made when echocardiography shows diffuse hypokinesis of the ventricles.
Patients experiencing cardiac discomfort should seek timely medical evaluation and treatment. Currently, there is no specific therapy available; treatment for myocarditis remains symptomatic.
