Myocarditis

Myocarditis means there is inflammation within the heart muscle. The condition usually occurs after a viral infection, but rarely, can be caused by bacteria, parasites or fungus.  Myocarditis affects the hearts ability to pump and the heart’s electrical system, making the patient at risk for arrhythmias.

With the right medical treatment, most children with myocarditis recover completely within a few months. Some children will need continuing care with a cardiologist.

The board-certified and fellowship-trained specialists at Norton Children’s Heart Institute, affiliated with the University of Louisville, have the experience and skill to diagnose and provide care for myocarditis.

The Society of Thoracic Surgeons has ranked Norton Children’s Heart Institute’s pediatric heart care among the best in the region. Norton Children’s has a network of outreach diagnostic and treatment services conveniently located throughout Kentucky and Southern Indiana.

Symptoms of myocarditis in infants

  • Fever
  • Fast heartbeat or arrhythmia
  • Fast breathing
  • Trouble feeding or working hard to breathe when feeding
  • Failure to thrive
  • Restlessness or irritability
  • Abnormal sweating
  • Little energy or no interest in anything
  • Low urine output
  • Pale or bluish hands and feet (cyanosis)
  • Vomiting

In older children, symptoms also can include cough; nausea; abdominal or chest pain; swelling in the legs, feet and face; and excessive tiredness.

Severe myocarditis can permanently damage your heart muscle. It can cause heart failure where the heart can’t pump blood effectively. In severe cases, myocarditis may need a ventricular assist device or a heart transplant because of their severe heart failure.

Since myocarditis affected hearts are not pumping blood effectively, the blood can pool in their hearts and put them at risk for blood clots. These clots can dislodge and have many bad effects, including strokes or a pulmonary embolism.

Because myocarditis affects the heart’s electrical system, arrhythmias or very fast heart rates may occur. These rhythms can further worsen the function of the heart making it pump less effectively. Some serious arrhythmias can make a patient’s heart stop beating which can be fatal if not immediately treated.

Diagnosing myocarditis

At Norton Children’s Heart Institute, your child’s pediatric cardiologist will need to run a number of tests and gather details about your child’s symptoms.

Tests may include:

  • Chest X-ray: This shows a picture of the heart and surrounding organs.
  • Echocardiogram (echo): This test uses sound waves (ultrasound) to produce images of the heart and blood vessels’ structures on a screen. It can show the structure and function of the heart. Norton Children’s Heart Institute has 28 tele-echo locations throughout Kentucky and Southern Indiana.
  • Electrocardiogram (ECG or EKG): This test checks the heart’s electrical activity to show damage or irregular rhythms.
  • Cardiac MRI (magnetic resonance imaging): This test uses radio waves, magnets and a computer to form three-dimensional pictures of the heart. These pictures can show structural issues (such as an enlarged ventricle) and help diagnose cardiomyopathies or myocarditis.
  • Endomyocardial biopsy (EMB): This procedure is performed through one of the large blood vessels in the neck or groin. A tiny piece of the myocardium (heart) is sampled during an EMB. This is done in an attempt to provide a diagnosis to the patient and family.
  • Heart catheterization:During this procedure, a thin, long tube called a catheter is inserted into a large blood vessel in the neck or groin and guided into the heart. This invasive procedure studies the structure, function, and provides direct pressure measurements of the heart.
  • Blood test: A polymerase chain reaction test can be done to check for a number of different infectious causes.

Myocarditis treatment

There is no one cure for myocarditis. Treatment focuses on the underlying cause, if found, and managing the symptoms of each patients. The inflammation often goes away on its own over time. Treatment typically focuses on helping the heart work better as it heals and may include:

  • Antimicrobial medicines to fight infection if an infectious cause is identified.
  • Steroid and immunoglobulin medicines to reduce inflammation.
  • Diuretics to help the body release excess fluid, reducing the heart’s workload.
  • Standard heart failure medications if the heart is particularly weak.
  • Blood-thinning medicine if the patient is at risk for blood clots
  • Medication or a device such as a pacemaker or defibrillator if arrhythmias are especially problematic
  • A ventricular assist device or a heart transplant in the most severe cases

Why Norton Children’s Heart Institute?

Norton Children’s Heart Institute, affiliated with the University of Louisville, is a comprehensive pediatric heart surgery, heart failure and heart transplant program serving Kentucky, Southern Indiana and beyond.

The goal of the full-service Norton Children’s Heart Institute is to provide care for the child and the whole family. Our specialists are prepared to repair even the most complex congenital and acquired heart conditions.

Our heart team includes:

  • Pediatric cardiothoracic surgeons
  • Pediatric transplant surgeons
  • Pediatric cardiologists
    • Fetal cardiologists
    • Adult congenital heart cardiologists
    • Heart failure/heart transplant cardiologists
    • Pediatric electrophysiologists
    • Pediatric cardiac catheterization cardiologists
  • Pediatric cardiovascular anesthesiologists
  • Pediatric intensive care physicians
  • Cardiac critical care nurses
  • Critical care pharmacists
  • Family support team
  • Child life specialists
  • Rehabilitation specialists
  • Social workers
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Norton Children’s Heart Institute

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