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While there are several contributing factors that may lead to myocarditis, the primary cause is viral. Myocarditis usually results from the Coxsackie B virus, and may also result from measles, influenza, chicken pox, hepatitis virus, or the adenovirus in children. If an acute onset of severe myocarditis occurs, a patient may display the following symptoms:
- rhythm disturbances of the heart
- rapid heartbeat (Ventricular tachycardia)
- left or right ventricular enlargement
- shortness of breath (Dyspnea)
- pulmonary edema (the accumulation of fluid in the lungs due to left-sided heart failure)
- swollen legs
- Additional causes of myocarditis include:
- bacterial infections, such as tetanus, gonorrhea,or tuberculosis
- parasite infections, such as Chagas' disease (which is caused by an insect-borne protozoan most commonly seen in Central and South America)
- rheumatic fever
- surgery on the heart
- radiation therapy for cancer that is localized in the chest, such as breast or lung cancer
- certain medications
As of 1996, research has shown that illegal drugs and toxic substances may also produce acute or chronic injury to the myocardium. These studies also indicate an increase in the incidence of toxic results from the use of cocaine. This illegal drug causes coronary artery spasm, myocardial infarction (heart attack), and arrhythmias, as well as myocarditis.
Further studies conducted in 1996 indicate that malnutrition encourages the Coxsackie B virus to flourish, leading to the potential development of myocarditis. Human immunodeficiency virus (HIV) is also now recognized as a cause of myocarditis, though its prevalence is not known.
Symptoms of myocarditis may start as fatigue, shortness of breath, fever and aching of the joints, all characteristic of a flu-like illness. In contrast to this type of mild appearance, myocarditis may also appear suddenly in the form of heart failure, or sudden cardiac death without any prior symptoms. If an inflammation of the heart muscle leads to congestive heart failure, symptoms such as swollen feet and ankles, distended neck veins, a rapid heartbeat, and difficulty breathing while reclining may all appear.
— Beth A. Kapes
