- Causes and consequences of myocarditis after COVID-19
- Symptoms of myocarditis after COVID-19
- How common is myocarditis after COVID-19?
- Diagnosis of heart inflammation after COVID-19
- Treatment of myocarditis after COVID-19
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Myocarditis after COVID-19 is another complication of coronavirus infection. Heart inflammation can occur both during an infection and several weeks or even months after contracting COVID-19. What are the symptoms of myocarditis after COVID-19? Who is most at risk of it? How is this ailment diagnosed and what are the treatment methods?
Causes and consequences of myocarditis after COVID-19
Myocarditis is an inflammatory heart disease characterized by inflammatory infiltrates and damage to the heart muscle without an ischemic cause. In the case of MSM after COVID-19, the direct cause of the disease is damage to the tissues and structures of the heart caused by the heart infection with the SARS-CoV-2 coronavirus. The immune system then causes inflammation in response to the infection.
The consequence of heart inflammation after COVID-19 may be its damage, and as a result - chronic heart failure, which in some cases may be so serious that the patient will require a heart transplant.
Symptoms of myocarditis after COVID-19
Myocarditis may develop both during COVID-19 infection and several months after recovery.
Symptoms of myocarditis following COVID-19, however, can vary. The most frequently reported are:
- fatigue
- shortness of breath
- chest pain
- fatigue
- feeling anxious
- palpitations
- ankle swelling
- chest pressure with exertion.
In severe cases of myocarditis after COVID-19, symptoms of tachycardia and acute heart failure may occur, as well as symptoms of right ventricular heart failure (e.g. increased pressure in the jugular vein, peripheral edema, pain in the right upper body ). In some patients, the so-called fulminant myocarditis with sepsis-like symptoms: fever, low blood pressure, cold extremities, sinus tachycardia.
How common is myocarditis after COVID-19?
It is not known yet,how common myocarditis occurs in people who have had COVID-19. Some experts assume that this complication may be the cause of as much as 7 percent. deaths related to COVID-19 - however, this is an assumption not yet confirmed by specific scientific data.
This complication is mainly observed in young adults and middle-aged people, as well as in children: it is very rare in people over 70 years of age.
Diagnosis of heart inflammation after COVID-19
Diagnosing myocarditis after COVID-19 infection is difficult, and a number of tests are required before diagnosis can be made. If DMS is suspected, an ECG test is necessary - this disease may be indicated by abnormalities observed in the ECG, e.g. changes in the ST segment, arrhythmias, decreased PR, prolongation of the QT interval, or premature ventricular syndromes.
You should also have cardiac magnetic resonance imaging and echo of the heart, in which cardiac dysfunction may be visible - symptoms of myocarditis on the echocardiogram include: increased thickness of the walls of the heart, dilatation of the ventricle and pericardial effusion against the background of systolic dysfunction of the ventricles. In turn, MRI of the heart in MSS may show swelling, cell damage, as well as hyperemia or leakage of capillaries.
It is also recommended to measure cardiac troponins in the blood serum (proteins that are part of the heart muscle cells) and the concentration of NTproBNP (a hormone released by the muscle cells of the heart chambers when their tone increases). In the course of myocarditis, their concentrations are usually increased due to damage to the heart muscle and possible expansion of the heart chambers.
Blood tests often show elevated levels of lactate and other markers of inflammation, including C-reactive protein, but these tests are not done routinely. Coronavirus testing should also not be done.
Myocarditis should also be differentiated from other heart conditions such as acute coronary syndrome, stress-induced cardiomyopathy (Takotsubo), sepsis-related cardiomyopathy.
Treatment of myocarditis after COVID-19
Treatment of MSM depends on the severity of symptoms. It is recommended to monitor the heart rate and use cardioprotective drugs, such as in heart failure.
Some patients need to receive glucocorticosteroids, immunoglobulins, and medications to maintain their blood pressure at an appropriate level.
In fulminant myocarditis, the following are used, among others: inotropic drugsand / or vasopressors, as well as mechanical ventilation, sometimes mechanical support for the circulation is also necessary.