Viral myocarditis: a latent heart "cold"

Author: Liu Wenxian, Chief Physician, Beijing Anzhen Hospital, Capital Medical University

Reviewer: Wang Fang, Chief Physician, Beijing Hospital

With the frequent occurrence of viral diseases, viral myocarditis, a heart disease, has gradually attracted people's attention. Viral myocarditis is caused by direct invasion of the myocardium by the virus, or damage to myocardial cells caused by the immune response triggered by viral infection.

1. What are the symptoms of viral myocarditis?

The early manifestations of viral myocarditis may not be obvious, but some common symptoms are worthy of vigilance. When the virus invades the myocardium, myocardial cells may degenerate and necrotize, which in turn causes edema and leads to decreased myocardial contractility. At this time, the patient may feel chest tightness and chest pain, which may not last and are easily ignored. In addition, inflammation may also stimulate the electrical activity of the heart, causing patients to experience arrhythmia symptoms such as premature beats and tachycardia, or affect the heart's conduction system, manifested as bradycardia, atrioventricular block, etc.

If viral myocarditis is not discovered and treated in time, the condition may further develop into protracted myocarditis, and the patient may experience symptoms of impaired heart function such as heart enlargement and decreased cardiac contractility, all of which will affect the patient's quality of life and ability to move.

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More seriously, fulminant myocarditis can progress rapidly, leading to life-threatening conditions such as heart failure and malignant arrhythmias. However, if treated promptly and effectively, patients with fulminant myocarditis may recover without leaving behind impaired heart function.

2. How to diagnose viral myocarditis?

The diagnosis of viral myocarditis is a comprehensive process. Although myocardial biopsy is considered the gold standard for diagnosis, it is relatively rarely used in clinical practice due to its invasiveness and certain risks.

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So, what tests do doctors usually use to determine if a patient may have viral myocarditis?

First of all, etiological examination is the key to determining viral infection. Doctors can determine whether there is a viral infection by testing throat swabs or virus-specific antibodies (such as Coxsackie virus antibodies).

Secondly, as a direct reflection of the heart's electrical activity, the electrocardiogram is also important for the diagnosis of viral myocarditis. The electrocardiogram of patients with viral myocarditis may show a variety of abnormalities, including arrhythmias (such as tachycardia, premature beats, bradycardia or malignant arrhythmias) and manifestations similar to myocardial infarction. These changes are important clues for diagnosis.

Myocardial injury markers, such as creatine kinase isoenzymes and troponin, will increase significantly when myocardial cells are damaged, so the detection of these markers is also important for the diagnosis of viral myocarditis.

In addition, cardiac color ultrasound, commonly known as echocardiography, can evaluate the structure and functional state of the myocardium, including myocardial inflammatory response, decreased contractility, and cardiac enlargement, providing important basis for diagnosis.

Finally, cardiac MRI examination can visually display the inflammatory changes of the myocardium and provide more accurate evidence for the diagnosis of viral myocarditis.

3. How to prevent viral myocarditis?

Preventing viral myocarditis is essentially preventing viral infection.

First of all, we must maintain good personal hygiene habits, especially after being in public places or contacting others, we should use the seven-step hand washing method to thoroughly clean our hands to reduce the spread of viruses and bacteria.

Secondly, pay attention to maintaining social distance and avoid close contact with people infected with the virus, especially in crowded or closed places. Maintain a reasonable social distance to reduce the risk of infection.

In addition, wearing a mask in public places or crowded places is also an important measure to effectively reduce the spread of the virus. Especially in winter and spring, when respiratory diseases and viral infections are prevalent, we must pay special attention to personal hygiene and protection, and avoid crowded and poorly ventilated places to reduce the risk of virus infection.

In addition to the above measures, enhancing immunity is also the key to preventing viral myocarditis. Through proper physical exercise and a balanced diet, the body's resistance can be improved, making it better able to resist the invasion of viruses.