Myocarditis
Channel: York Cardiology
Date: 2023-06-24

One cardiac condition that has gained a lot of prominence especially during the COVID-19 pandemic is Myocarditis and I have lot of patients who come to see me with symptoms of palpitations, breathlessness and exercise intolerance after catching COVID-19 who are worried that they may have developed Myocarditis. 

In this video, I will discuss Acute Myocarditis.

Myocarditis basically means inflammation of the myocardium. 

The myocardium is the middle and therefore the most important layer of the heart (it lies between the epicardium and endocardium) which contains all the cardiac muscle cells which are responsible for the conduction of electricity of the heart and also regulate the contraction and relaxation of the heart. 

If the myocardium is inflamed and damaged then it can lead to problems with electrical conduction and therefore lead to heart rhythm disorders and it can also lead to ineffective contraction and relaxation of the heart which is termed heart failure. 

So the problem with myocarditis is that depending on the severity and extent of inflammation, the patient is prone to dysrhythmias (heart rhythm disturbances) and heart failure - both of which can be life-threatening.

How common is it?

Data from all NHS admissions from 1998-2017 suggest that there were about 13000 hospital admissions with a primary diagnosis of Myocarditis over a 19 year period although this is likely to be a gross underestimate because a significant proportion of patients may with the condition may have not had symptoms to the extent that they presented to hospital and it is not uncommon for diagnoses like ‘myocarditis’ to be missed at the time of admission. I am very confident that we have had a lot more admissions with myocarditis during the COVID pandemic partially because of the virus itself but also because of increased awareness of myocarditis amongst patients and healthcare professionals as a consequence of it being found to be a dangerous consequence of COVID infection.
If we look at these patients who were admitted, 2/3rds were men and compared to women, the median age of these men was about 33 years and the median age of women was about 46 years.