Amidst the COVID-19 pandemic, a relatively rare heart condition called myocarditis has garnered a lot of media attention.

Myocarditis, COVID-19 and Other Offenders

Identified as inflammation of the heart muscle, acute myocarditis is most often caused by infection with a virus. Historically, viruses such as the common cold, hepatitis B and C, the herpes simplex virus and parvovirus were the most common offenders, but COVID-19 has emerged as a common trigger for inflammation of the heart muscle. In some cases, even the COVID-19 vaccine has been known to trigger myocarditis, although the incidence is more common in adolescent males. In other cases, bacteria, fungi or parasites can cause myocarditis.

Symptoms of Myocarditis

Symptoms to be on the lookout for include chest pain, fatigue, shortness of breath or fluid build-up/swelling of the legs, feet and ankles, although some patients will have no symptoms at all.

Effects of Myocarditis

The good news is that many cases of myocarditis – particularly mild cases, will resolve within a few days
with little to no treatment. However, when myocarditis is severe, it can lead to rapid and lasting effects on the heart. That’s because when inflammation attacks the heart, it can reduce the organ’s ability to pump. This can cause rapid or irregular heart rhythms or heart failure over time. Severe myocarditis (which is rare) can lead to heart attack, heart failure, or sudden cardiac arrest.

Diagnostic and Treatment Options

WakeMed Heart & Vascular physician Raj Fofaria, MD, explains that treatment for myocarditis isn’t the same for every patient. “When we’re treating inflammation of the heart, we’re looking carefully at what symptoms the patient is experiencing and their severity, which will help us develop an individualized treatment plan,” he explains. “For patients experiencing mild symptoms, we often use anti-inflammatory medications to treat inflammation, or medications to address symptoms such as heart failure or rhythm problems.” For patients with severe myocarditis or unresolved rhythm problems, more aggressive treatments or procedures may be required.

Diagnosing myocarditis early (when it’s in the mild stages) can help improve outcomes and prevent long-term damage to the heart.

“Fortunately, with uncomplicated (mild) myocarditis we see most patients resolve their symptoms after a few weeks or months.” After a patient’s acute myocarditis is resolved, the chances of reoccurrence are low.

For patients who have recently had COVID-19 or even those who have had the vaccine, it’s important to be aware of any changes in how you’re feeling and consult with your doctor if you notice any new symptoms.

Patients with COVID-19 16X Higher Risk of Getting Myocarditis

“While there’s been a lot of attention given to vaccinerelated myocarditis, inflammation of the heart is far more common in patients who actually have COVID-19,” explains Dr. Fofaria. “According to the CDC, patients with COVID-19 have a 16 times higher risk of getting myocarditis than those without COVID-19. We strongly believe that vaccination – particularly for patients with an underlying heart condition – is the best way to protect yourself from both myocarditis and the dangers of COVID-19.”

What to Do If You Suspect Myocarditis

If you are concerned about myocarditis, consult with your provider who may perform blood tests, an EKG or echocardiogram, or imaging studies (e.g. chest X-ray or cardiac MRI) to try to get to the root of your symptoms.