Condition: Myocarditis and pericarditis

Myocarditis and pericarditis are inflammatory conditions that affect the heart. Myocarditis is inflammation of the heart muscle (myocardium), while pericarditis is inflammation of the outer lining of the heart (pericardium).

Myocarditis and pericarditis usually happen independently of each other, but can sometimes happen together (myopericarditis), and they have similar symptoms. These conditions can cause worrying symptoms but most people make a very good recovery with specialist treatment.

Myocarditis is most commonly caused by a virus, like the flu or COVID-19, or another viral infection. It can also be caused by:

• A bacterial infection, such as a sore throat, chest infection or fungal infection
• Autoimmune diseases like lupus
• A reaction to a toxin like carbon monoxide, illegal drugs such as cocaine or certain medicines or vaccines
• Myocarditis can also be caused by the COVID-19 Vaccine, but this is not common.

Pericarditis is also most often caused by a virus, such as the common flu virus or COVID-19, but also inflammatory conditions, like rheumatoid arthritis. Less common causes include:

• A chest injury or trauma, for example after a road accident, heart surgery, or heart attack
• Other health conditions, like kidney failure or hypothyroidism
• Certain medicines or vaccines

The symptoms of myocarditis and pericarditis can be very similar, with chest pain and breathlessness being the most common.

Symptoms of both myocarditis and pericarditis can  include:

• Chest pain
• Shortness of breath, at rest or during activity
• Fatigue
• Swelling in the hands, legs, ankles or feet
• Heart palpitations
• An 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
• Shortness of breath
• A dry cough
• Heart palpitations
• Fatigue
• A high temperature and feeling hot and shivery
• A sore through
• Feeling sick
• Feeling light-headed

To diagnose myocarditis or pericarditis, your specialist will evaluate your symptoms, do a physical examination and take a detailed medical history. You may also need to have further tests including an electrocardiogram (ECG), echocardiogram, chest x-ray, CT of the chest and a cardiac MRI in some cases,  and blood tests

The treatment options for myocarditis and pericarditis depend on your symptoms and the cause of the condition.

Treatments may include:

• Painkillers or analgesics to relieve chest pain
• Anti-inflammatory medications
• 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.

If you have pericarditis, steroids may be prescribed, and in severe cases, a surgery called a pericardial window may need to be performed to drain the inflamed lining surrounding the heart.