Myocarditis and Pericarditis

The symptoms of myocarditis and pericarditis can be very similar. Chest pain and breathlessness are the most common.

Symptoms of both myocarditis and pericarditis can include:

• chest pain (in pericarditis, this may get better when you lean forward)

• shortness of breath, at rest or during activity

• fatigue

• swelling in the hands, legs, ankles, or feet

• heart palpitations

• irregular heartbeat

• feeling lightheaded or fainting

• flu-like symptoms such as headache, body aches, joint pain, fever, or sore throat

• stabbing chest pain that’s worse when breathing in, coughing, swallowing, or lying down

• chest pain that spreads to your arms, shoulders, and back

• dry cough

• feeling sick

Myocarditis and pericarditis can both happen for no obvious reason. When a reason is clear, it’s most often a virus, such as the flu or COVID-19. Symptoms can start to show 1 or 2 weeks later as your body overreacts to the infection and causes inflammation that can last after the virus has gone.

Other causes of myocarditis can include:

• bacterial infections, such as a chest infection

• fungal infections, such as athlete’s foot

• autoimmune diseases, such as lupus

• connective tissue diseases

• reacting to certain medicines or vaccines, carbon monoxide, heavy metals, or drugs such as cocaine

• radiotherapy

Pericarditis is also often caused by inflammatory conditions, such as rheumatoid arthritis.

In rarer cases, pericarditis can be caused by:

• a chest injury or trauma, for example, after a heart attack, accident, or heart surgery

• another health problem, such as rheumatoid arthritis, lupus, scleroderma, an underactive thyroid, kidney failure, or cancer  

• certain medicines or vaccines

Are there any risk factors?

Risk factors for myocarditis include:

• being a young adult – but people of all ages can get it

• bring male – but females also get it

• your body reacting to inflammation in an unusual way, which can have a genetic element

• drinking more alcohol than the weekly 14 units

Risk factors for pericarditis include:

• being in your first year of life

• being aged between puberty and your early 30s

• being male, you’re 2 times as likely to get it – but females also get it

Diagnosing your myocarditis and/or pericarditis usually involves an initial consultation where our heart health specialist will:  

1. Take a history to get a full understanding of your family history, health status

2. Ask about your symptoms and how they affect you – for example, how severe they are, where they are, what makes them worse or better, and how they affect daily life. They’ll want as much detail from you as possible because this can help narrow down the cause.

3. Do a physical examination, including listening to your heart.

4. Review any relevant scans and other previous investigations.

5. Talk through their initial findings and what will happen next.

They may also recommend :

• blood tests

• electrocardiogram (ECG) to check your heart’s electrical activity

• echocardiogram (echo) to check for fluid around your heart

• chest X-ray

• scans such as CT or MRI 

Your consultant may work to rule out other causes of chest pain, too. These include:

• angina

• acid reflux

• pleurisy

• pericarditis

• muscular pains

There’s no known way to prevent these conditions – except potentially by reducing the number of infections you get, by:

• washing your hands regularly with soap and water

• regularly cleaning high-touch areas such as light switches, remote controls, mobile phones, and door handles

• giving your immune system support with healthy eating, regular sleep, regular activity, and no smoking

The key thing is to seek medical attention and get a speedy diagnosis and treatment – this may help cut the risk of the condition developing again and developing complications.

Complications are rare - most people make a good recovery with specialist treatment.

Myocarditis complications can include:

• heart conditions such as cardiomyopathy, arrhythmia, and heart failure

• lung issues

Pericarditis complications can include:

• chronic pericarditis if your condition goes untreated

• constrictive pericarditis, when scar tissue builds up, and you may need surgery - if bacteria or tuberculosis caused your pericarditis, you may have up to a 30% risk of this

• cardiac tamponade, a medical emergency when your heart gets restricted by fluid build-up due to pericarditis – it’s more likely to happen when cancer or infection causes your pericarditis.

Once your myocarditis and/or pericarditis have been diagnosed, and your consultant is clear about the possible cause or causes, they’ll recommend the most appropriate next steps and will arrange treatment to ensure you make the best possible recovery. Treatment options include:

• painkillers to relieve chest pain

• anti-inflammatory medications such as ibuprofen or stronger medicines such as colchicine if your condition continues for more than 2 weeks or comes back

• antibiotics to treat a bacterial infection

• in some cases, medicines to suppress the immune system, such as steroids and other more specific drugs, need to be used

• in severe cases of pericarditis, you may need a surgery called a pericardial window to drain the inflamed lining surrounding the heart

• in severe cases of myocarditis you may need options such as heart failure medicines, or surgery to insert a pacemaker to control an abnormal heart rhythm

Our consultants have access to multidisciplinary teams who can be brought in to support your personalised myocarditis and/or pericarditis management plan.

At Welbeck, our heart health specialists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.