Myocarditis Disease with Causes, Treatment and Nursing Intervention

Definition of Myocarditis Disease or Myocarditis Virus:

Myocarditis disease or Inflammatory cardiomyopathy is an inflammation of the myocardium, the middle layer of the heart wall.

Causes of Myocarditis Disease or Myocarditis Causes:

There are different causes of myocarditis, which are mentioned below:

1. Infection:  

• Viruses: Coxsackie virus-B, Parvo-Virus-B19, Rubella.
• Bacteria: Staphylococcus, Streptococcus.
• Parasites: Trypanosoma, Cruz.
• Fungi: Candida Molds.

2. Medications or Illegal Drugs: Allergic, Toxic reaction),
3. Connective tissue disorders (Scleroderma, Systemic lupus erythematosus),
4. Wegener’s granulomatosis,
5. Electric shock,
6. Radiation induces,
7. Hyperpyrexia.

Sign and Symptoms of Myocarditis Disease or Myocarditis Symptoms:

Various sign and symptoms of myocarditis are the following:

1. Shortness of breath during exercise,
2. Fatigue,
3. Palpitations lightheadedness,
4. Irregular heartbeat,
5. Sudden loss of consciousness,
6. Fever,
7. Bluish or Grayish discoloration of the skin,
8. Fluid retention with swelling of legs, ankles, and feet,
9. Headache,
10. Body aches,
11. Sudden breath.

Test and Diagnosis for Myocarditis Disease:

There are different test and diagnosis ways for myocarditis, which are mentioned below:

1. ECG,
2. Chest X-Ray,
3. Echocardiogram,
4. Holter monitor,
5. Blood test (CBC, CRP),
6. MRI,
7. Cardiac catheterization and endomyocardial biopsy,
8. Rheumatologic screening,
9. Viral genome testing in an endomyocardial biopsy,
10. Cardiac angiography,
11. Cardiac enzyme levels (eg, creatine kinase or cardiac troponins)
12. Serum viral antibody titers.

Treatment for Myocarditis Disease:

Various treatment options for myocarditis disease are in the following:

1. Medication:

• ACE Inhibitors (Enalapril, Captopril) to relax the blood vessels and increase cardiac output.
• Angiotensin-2 receptor blockers (Losartan, Valsartan) to relax the blood vessels in the heart and help blood flow more easily.
• Beta-Blockers (Metoprolol, Bisoprolol) to control irregular or fast heart rhythms.
• Diuretics (Furosemide) to reduce fluid overload and sodium retention.
• Antibiotics (To treat bacterial infection).
• Non Steroidal Anti-inflammatory Drugs (To relieve pain and inflammation).
• Anticoagulant (Aspirin) to prevent blood clots.
• Inatrops (Dobutamine, Dopamine) may be necessary for severe decompensation.

2. Supportive:

• Oxygen Supplement,
• Fluid management,
• Low Sodium Diet,
• Hemodynamic and cardiac monitoring,
• Reduced activity.

3. Surgical:

• Temporary Transvenous pacing.
• A temporary artificial heart,
• Intra-aortic balloon pump.
• Ventricular assist device or percutaneous circulatory support; left ventricular assistive devices (LVADs) and extracorporeal membrane oxygenation(ECMO) [5].

A complication of Myocarditis Disease:

There are different complications for myocarditis, those are mentioned below:

1. Heart failure,
2. Heart attack or stroke,
3. Irregular heartbeats.

Nursing Intervention for Myocarditis Disease:

Different nursing interventions for myocarditis disease are in the following:

1. Give a comfortable position (semi-fowler position).
2. Monitor pain characteristics and administer analgesics as needed and use salicylates around the clock.
3. Give O2 supplement and ensure saturation ˃90%.
4. Give drugs as indicated (Aspirin, Steroids).
5. Give antipyretic drug if fever present.
6. Provide a calm and quiet environment and give emotional support while the patient is confined to a hospital or home with restrictive intravenous therapy.
7. Check vital signs and record them carefully.
8. Carefully monitor intake output.
9. Closely monitor signs for cardiac tamponade.
10. Ensure bed rest to reduce myocardial oxygen requirements and reduce heart rate.
11. Ensure rest and activity according to the degree of tolerance.
12. Ensure a high protein, high carbohydrate, and low sodium diet to meet adequate nutrition.
13. Explain all procedures to patients that improve patient confidence.
14. Prepare patient for surgery if needed
15. If the patient received surgical treatment, provide post-surgical care and instruction.
16. After surgery, monitor the patient’s temperature, fever may be present for weeks.
17. Provide 4 hourly mouth cares and serve attractive meals that stimulate the appetite.
18. Instruct to avoid people who have an upper respiratory tract infection.
19. Monitor for signs and symptoms of organ damage such as stroke (CVA, brain attack), meningitis, heart failure, myocardial infarction, glomerulonephritis, and splenomegaly.
20. Instruct patient and family about activity restrictions, medications, and signs and symptoms of infection.

More questions related to this topic:

1. Myocarditis Causes, Symptoms, Diagnosis, and Treatment.
2. Causes of Myocarditis, Types of Viruses, Bacteria Cause.
3. Myocarditis: Symptoms, Treatment, and Diagnosis.
4. Myocarditis: Causes, Symptoms, and Treatments.
5. Myocarditis Definition.

Maria Mona

Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “[email protected]”