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Reviewed on 4/29/2021

What is myocarditis?

Picture of heart



  • Lymphocytic: Heart muscle infiltrated with lymphocytes
  • Eosinophilic: Heart muscle infiltrated with eosinophils
  • Autoimmune: Caused by autoimmune diseases, such as lupus
  • Acute: Symptoms appear rapidly and usually decrease after a week or two

What causes myocarditis?

The causative agents that damage myocardium include the following:

  • Chemicals released during myocardial cell death
  • Autoimmune responses can also trigger myocardial inflammation
  • Certain diseases like lupus, Wegener's granulomatosis, and others

About half of the time, the triggering agent for myocardial inflammation is not known (idiopathic). This is especially true in pediatric population where the majority of patients are diagnosed with idiopathic myocarditis.

What are symptoms of myocarditis?

Myocarditis can be mild and cause virtually no noticeable symptoms. The most frequent symptom of myocarditis is pain in the chest. Other symptoms are related to the underlying triggering cause, like infection or an autoimmune disorder. The following is a list of symptoms and signs of myocarditis:

Myocarditis in children and infants has more nonspecific symptoms:


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How is myocarditis diagnosed?

Myocarditis is preliminarily diagnosed by detecting signs of irritation of heart muscle during the patient's history and physical exam. Blood tests for heart muscle enzymes (CPK levels) can be elevated. Electrical testing (EKG) can suggest irritation of heart muscle and document irregular beating of the heart. Nuclear heart scan testing can show irregular areas of heart muscle. Other tests to help definitively diagnose myocarditis include chest X-rays to determine the size and shape of the heart, MRI, and echocardiogram. Sometimes cardiac catheterization with heart muscle biopsy (endomyocardial biopsy) may be done to definitively determine the likely underlying cause for the disease.

What is the treatment for myocarditis?

Often, myocarditis improves on its own without treatment with complete recovery. Sometimes, treatment of the underlying cause (such as bacterial infections) can lead to complete recovery (for example, after antibiotics). Consequently, the diagnosis of the precise underlying cause of myocarditis can help in the optimal choice of treatment.

However, in patients with more prolonged or more severe cases of myocarditis, individuals may need more specific medications or even hospitalization. Medications to reduce the heart's workload and/or reduce edema are commonly used to treat symptoms of myocarditis. They may include the following:

Individuals with severe symptoms of myocarditis (heart failure, acute shortness of breath) may require other treatments such as IV medications and/or vascular assist devices (pumps that help a weak heart pump) or extracorporeal membrane oxygenation (ECMO) to help provide oxygen to the blood. Occasionally, patients may require a heart transplant. Individuals who develop very irregular heartbeats (arrhythmias) may need an implanted pacemaker.

What is the prognosis (outlook) for patients with myocarditis?

The prognosis for patients with acute myocarditis who rapidly recover is very good. Even patients that develop severe myocarditis can completely recover with mild or no complications. However, if damage to the heart muscle becomes chronic and/or progressive, the prognosis for the patient declines. Those who develop severely weakened heart muscle cardiomyopathy have a poorer prognosis.



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"Discover Myocarditis Causes, Symptoms, Diagnosis and Treatment." Myocarditis Foundation. 2015.

Tang, W. H. W., et al. "Myocarditis." Medscape. 5 Sept. 2014.

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