Little girl Nora, 8 years old, has always been in good health. However, she started to have symptoms such as runny nose and cough a week ago. She originally thought it was a cold, but in the past two days, her mother found that she seemed to become tired easily, even turned pale, and broke into cold sweats. He quickly took her to the hospital for examination. The doctor diagnosed her with acute myocarditis and required immediate hospitalization.

What are the causes of acute myocarditis? How is it different from blast myocarditis? How to treat to effectively relieve uncomfortable symptoms? We will answer it for you in this article!

What is acute myocarditis?

Acute myocarditis is a disease symptom caused by viral, bacterial or parasitic infection of the heart. Most cases are caused by acute viral infection of the heart muscle, such as: Parvovirus B19, Coxsackievirus ) or adenovirus. Patients will have obvious ventricular dysfunction, which may lead to cardiogenic shock in severe cases. After the infection is over, in some severe inflammation conditions, the condition may become aggravated and transform into dilated cardiomyopathy.

Don’t ignore sudden attacks of acute myocarditis and blast myocarditis

According to the clinical pathological classification, acute attacks of myocarditis can be divided into acute myocarditis and blast myocarditis, but the latter is less likely to occur and is generally caused by the exacerbation of acute myocarditis, accounting for only 1% of patients with acute myocarditis.

Differences in symptoms between acute and blast myocarditis

Many patients with acute myocarditis have cold symptoms at the beginning, so they are easily misdiagnosed as influenza or a common cold. Possible symptoms include chest pain, difficulty breathing, fever, headache, palpitations, fatigue, fainting, etc. Patients with acute myocarditis generally have mild initial symptoms. If diagnosed early during this period, their recovery is quite good.

Although blast myocarditis is also myocarditis, the initial symptoms will be very severe heart failure and arrhythmia; because the symptoms worsen rapidly and the number of myocardial cell necrosis is excessive, severe cardiogenic shock will occur in the early stage. Without timely treatment, the mortality rate is very high.

Blast myocarditis may lead to cardiogenic shock or severe arrhythmia, and the risk of death is very high; however, if treated immediately, combined with ECMO or other cardiopulmonary maintenance devices, patients with blast myocarditis can maintain blood circulation. This can effectively reduce mortality.

How is acute myocarditis diagnosed?

In the early stages of myocarditis infection, some symptoms are actually similar to influenza, but when the condition worsens, some symptoms are similar to acute coronary heart disease. Therefore, it is not easy to diagnose myocarditis. There are four main diagnostic methods:

Blood test (Hematology Test): Determine the inflammation of the myocardium by detecting specific Biomarkers, for example, measuring white blood cell and red blood cell counts, and detecting cardiac enzymes such as Troponin and Creatine kinase, Myoglobin and Lactate dehydrogenase, etc.

Electrocardiography: Patients with myocarditis may have symptoms such as tachycardia, arrhythmia, or conduction block, all of which can be detected through electrocardiography. Patients with myocarditis may also have an electrocardiogram pattern with an elevated ST segment.

How to treat acute myocarditis?

The treatment of myocarditis generally focuses on using supportive therapy to allow patients to maintain their strength and treat derived complications. Initially, drugs such as diuretics and Angiotensin Converting Enzyme Inhibitors (ACEI) may be used to improve heart failure.

If it is more severe acute myocarditis or blast myocarditis, the patient may develop complications such as pulmonary edema and arrhythmia. At this time, corresponding treatment is required according to different symptoms; depending on the condition, a ventricular assist device may be required (VAD for short), intra-aortic balloon pump (IABP for short) or membrane to maintain normal circulation of the patient’s heart and lungs. If the heart failure does not improve, heart transplantation must finally be considered.

When the patient is out of the dangerous period, the only thing left is to continue to maintain supportive therapy so that the patient can slowly recover through his own immunity. However, in some cases, moderate immunosuppressive treatment may be needed to help patients relieve symptoms.

How to prevent acute myocarditis?

No matter what type of myocarditis it is, the main route is infection of myocardial tissue. It is recommended that the following four methods should be used to reduce the risk of bacteria invading the human body and causing acute myocarditis:

1. Eat a balanced diet, have a normal schedule and avoid staying up late to maintain your body’s immunity.
   
2. Get a flu shot.
   
3. If you have a cold or flu, please wear a mask to avoid spreading it to others and go to a clinic for treatment as soon as possible.
   
4. Maintain good personal hygiene habits, wash your hands frequently, and wear a mask when going to crowded public places.