Acute myocarditis is an inflammation of the heart muscle. Most cases are infectious, caused by bacteria, virus, or fungus, but toxins, drugs and immunological disorders are also very common causes.

Infectious myocarditis most often follows a respiratory infection. Viral myocarditis is the most common form, and the viruses most implicated are influenza and Coxsackie virus. Most affected individuals present with a several day to several week history of chest pain following the onset of a fever or respiratory infection. Some may present in heart failure without any real antecedent symptoms at all. Pain that gets worse with a deep breath is common. Doctor's examination shows a fast heart rate, a gallop rhythm, and signs of heart failure or a heart conduction defect.

When myocarditis is suspected, an echocardiogram is done, which visualizes the size of the heart chambers, the heart valves, and the efficiency of pumping power that the heart has. Sometimes a dye is infused (gallium) to see how much activity the heart has maintained. An echocardiogram often demonstrates an enlarged heart, a decrease in the effectiveness of pumping, and a low amount of blood pumped out with each heartbeat (called the ejection fraction). In very severe or difficult to diagnose cases, a biopsy of the heart tissue will show characteristic changes of myocardial inflammation.

Bacterial infections are not uncommon causes of myocarditis. Diptheria, typhoid and tuberculosis are common abroad, and Lyme disease and Rocky Mountain spotted fever are common here in the United States. HIV is associated with myocarditis in over half of all cases of people dying from AIDS infection. Sometimes autoimmune diseases (such as rheumatoid arthritis or lupus) may be causes.

Most cases resolve spontaneously, but in others cardiac function deteriorates progressively and may lead to permanent heart damage and decompensation. Many cases of the serious disease dilated cardiomyopathy (with heart failure) may be the end stage of myocarditis.

Generally most who recover from myocarditis with a normal EKG and echocardiogram are issued standard or preferred insurance unless the cause of the myocarditis (alcohol, toxins, underlying immune system disease, etc.) represents an additional risk. Those who have permanent heart changes but have been stable for a number of years may be considered for rated policies depending on how severely the heart is affected.

The information contained on this page is not intended to provide medical advice, which should be obtained directly from your physician.