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August 12, 2020

How a Viral Infection Can Affect the Heart

What is Viral Heart Disease?

Viral Heart disease is also termed as Myocarditis, which is a heart disease that is affected by the virus. The muscles of the heart are attacked by the virus, which causes inflammation and distorting the electrical pathways that would provide signals to the heart for beating properly. Major of the time, the healing of the body would happen on its own and one never knows what issue they were suffering from. In a rare situation, the heart gets harmed or weakened due to infection or inflammation. This might also occur in those individuals who may be in proper health.

This condition results in the heart getting weak affects the ability of the heart to pump appropriate blood to the entire body and causes the abnormal beating of the heart i.e. arrhythmias and finally failure of the heart.

The common viruses that might affect the heart are adenovirus (virus for the common cold), the rubella virus (German measles) and Coxsackievirus B (Virus which results in flu-like symptoms).

This condition affects less of the women and more of the men. The average age of the patient is 42 years.

For some individuals, viral heart condition would be flu-kind of symptoms. Many viruses would affect the heart, only some of them are connected to myocarditis and heart diseases.

Sometimes viral myocarditis could get confused with flu, though it is inflammation of the heart muscles. Individuals who suffer from viral myocarditis, may not experience or undergo any symptoms instead they might experience a heart attack or heart failure which is acute as and when the condition becomes worse.

As per the department of Cardiothoracic Surgery at National Health Center Singapore (NHCS), Viral Myocarditis could be the factor for a notable quantity of deaths that are immediate and unexplained in young individuals which are healthy. As we know this might happen as viral myocarditis is confused about having flu-like symptoms like fever, tiredness, and palpitations of the heart.

If women suffer from viral myocarditis in the last month of their pregnancy stage, it could result in heart disease termed as post-partum cardiomyopathy.

The majority of the individuals with myocarditis get well without any complications, but rarely if there is severe inflammation it results in damage to the heart.

Types of Viruses

Adenovirus

This is a very common cause that, where the myocarditis is affected by the virus in both children and adults. It majorly results in respiratory infections. It might also result in infections of the bladder or bowel. The virus could also spread via an infected person’s nose or throat droplets.

Cytomegalovirus (CMV)

This normally includes herpes simplex viruses, varicella-zoster virus (that results in chickenpox and shingles i.e. results in a painful rash and the Epstein Virus Barr (mononucleosis). As per the Centers for Disease Control and Prevention (CDC), out of each 100, at least 50 people are affected by this particular virus once they get to the age of 40 years. Epstein – Barr virus, would affect approximately 90 percent of the adults.

This virus could remain in the body without any harm or resting, but could result in infection of the heart by a virus. These viruses would grow when in touch with the fluids of the body or if a person is affected by an infection. This virus could also transmit from a woman who is pregnant to her baby during her pregnancy.

Coxsackievirus B

About 50% of the cases affected by myocarditis, this virus is to be criticized. It could result in an infection that would stay from 2 to 10 days, flu/fever or heart attack. In just two weeks, heart attack symptoms would also appear. The symptoms would consist of fever, tiredness, and pain in the chest. It normally does not result in death, but might cause damage to the heart, majorly if it occurs again. Mode of transmission is fecal material, could be prevented by hand washing and oral hygiene needs to be improved.

Enteric Cytopathic Human Orphan Viruses (ECHO)

This sort of virus results in issues of the gastrointestinal tract (GI) and skin rashes. The virus could result in myocarditis. The mode of transmission for the virus is when it gets in touch with stool being contaminated or when air particles are taken in while breathing from an infected person.

Human Parvovirus B19

This particular virus results in “fifth disease”, a disease which is marked by mild rashes, which is more seen among children than adults. This is also linked with severe myocarditis. The mode of transmission is via saliva or mucus of the nose. Precaution should be to wash hands, to cover mouth and nose while sneezing or coughing to reduce the virus to be spread.

Rubella

This virus results in German measles, this results in infection of the heart via a virus. It is also linked with miscarriages, still-births, and defects at the time of birth. It could result in myocarditis, if the heart is infected, though not that “common.” Vaccination for this virus is available.

Symptoms

In the case of viral infection, the symptoms go unnoticed. The symptoms that are observed are listed below:

  • Abnormal heart-beat
  • Pain in the chest
  • Tiredness
  • Fever
  • Aches in the muscles
  • Soreness of the throat
  • Pain in the joint or leg or swelling
  • Breathlessness or faint feeling
  • Light-headedness

Tests for Diagnosis of Myocarditis (Viral Infection)

Blood Tests: For checking of “infection, antibodies or blood cell counts.” By doing blood tests it would also help identify the “antibodies against the viruses” and other micro-organisms that could result in infection related to myocarditis.

X-Ray for the chest so the physician can check for the heart, lungs and other structures of the chest.

An Electrocardiogram (EKG) for recording the electrical activity of the heart.

Ultrasound of the heart (Echocardiogram) for the formulation of the photo and structure of the heart.

Cardiac Catheterization and endomyocardial biopsy: In the vein of the leg or neck, it is inserted a small tube (catheter) that is connected/”threaded” to the heart. In few cases, the physician uses special equipment for the removal of a small part of the tissue from the heart muscles (biopsy) for analyzing in the laboratory for checking of inflammation and/or infection.

For further confirmation, sometimes physician would demand MRI scans or biopsies of the heart muscles.

When should the Doctor be called?

If the symptoms of Myocarditis are been showing up, call the physician immediately.

Important to get instant medical care if the symptoms are too acute.

If any of the symptoms such as pain in the chest, breathlessness, swelling or worse as you were informed about your condition of myocarditis, do go to the hospital or seek immediate medical care treatment.

Treatment

If an individual is diagnosed with myocarditis, the physician would treat the cause. He might also take the excess pressure of the heart, if required and would take some actions to avoid or “control complications.”

Medicines would be prescribed by the doctor for the heart to work effectively. These would include:

ACE Inhibitors (Angiotensin Converting Enzyme): The medicines include like “enalapril (Vasotec), captopril (Capoten), lisinopril (Zestril and Prinivil), ramipril (Altace)”, works by relaxing the blood vessels in the heart and there is easy passage of blood flow.

Beta-Blockers: These include metoprolol (Lopressor, Toprol-XL), bisoprolol and carvedilol (Coreg), these help in the treatment of heart failure and controls irregular rhythms of the heart.

Diuretics: These include such as furosemide (Lasix), which decreases the retention of sodium and water.

Calcium Channel Blockers

In acute cases, the treatment includes:

Intravenous Medications (IV): This helps in increasing the pumping function of the heart at a rapid rate.

Ventricular Assist Devices (VADs): These are pumps that are mechanical in work, helps in the pumping of the blood from the ventricles i.e. the lower chambers of the heart to the other parts of the body. This is helpful in an individual whose heart is weak or failure of the heart. This method helps in recovery of the heart or waiting for other treatments like a transplant of the heart.

Intra-aortic balloon pump: In this method, X-ray imaging is used for checking the heart, by putting a narrow tube (catheter) in a blood vessel situated in the leg. The physician attaches a balloon at the “end of the catheter”, inside the major artery which exits the body from the heart (aorta). With the inflation and deflation of the balloon, it helps with the increase and decrease of the flow of blood to reduce the load of work on an individual’s heart.

Extracorporeal Membrane Oxygenation (ECMO): This equipment helps with the provision of oxygen to the body when an individual is suffering from a failure of the heart. The blood is removed and transferred to this machine termed as ECMO machine, which eliminated Carbon-Dioxide and provides “oxygen to the blood.” The oxygenated blood comes back to the body.

In addition to this, the physicians might also recommend a decreased activity and rest for approximately 6 months. Also might be to avoid the fluid build-up, the physician might keep you on a low-salt diet.

If an individual is having any of the two symptoms such as blood clots or a weak heart, they might have to get admitted. If the heart rhythms are not normal, some other medicines might be required, a pace-maker, “or an implantable cardioverter-defibrillator.”

A few of the times, life-long medications might be needed if the disease is long-term or not reversible, while some would require only for a short period and then would completely recover. Important would be proper and on-time follow-ups which also consists of tests to analyze the condition.

The interpretation depends on the things as mentioned below:
  • Myocarditis causes
  • The complete health of an individual
  • If any complications

Even though overall recovery is done or a chronic condition is present, important to consider the follow-up which guides to avoid any sort of problems that are going on or in progress. Though Myocarditis is not that common, it might reoccur again.

Complications for Viral Infection (Myocarditis)

If this condition is not treated it might result in the symptoms of failure of the heart, in which the heart has problems/issues in the pumping of the blood as it would do before. Very rarely it results in other issues such as

Cardiomyopathy: In this condition, the muscles of the heart become weak and the structure of the muscles of the heart also differs.

Pericarditis: Inflammation of the pericardium i.e. sac that protects the heart. One of the main/major causes for transplant of the heart in the United States (US), is myocarditis and cardiomyopathy. Very rarely, myocarditis could result in “sudden death.”

Prevention

Ways to prevent myocarditis (viral infection)
  • Till the time individuals with viral fever are not recovered, do stay away from them: Try to avoid the exposure, if an individual is suffering from any viral symptoms.
  • Good hygiene needs to be followed: Important to avoid any diseases or illnesses to be spread, so follow a routine of regular washing of the hands.
  • Any risky behaviors need to be avoided: To avoid the possibility/probability of getting exposed to any HIV-related myocardial infection/disease, sex should be safe and avoid the usage of illegal drugs.
  • Avoid exposing one-self to tick i.e. parasites. Important to cover your body at the time of visiting a tick- invaded area. Application of “tick or insect repellent that contains DEET (active ingredient for repellents).”
  • Important to vaccinate: Important to vaccinate on time, especially for rubella and influenza diseases that result in myocarditis i.e. viral infection.

Conclusion

Viral heart conditions occur when the virus harms the muscles of the heart. This results in inflammation and disturbances in the “electrical pathways”, which would “signal” for the appropriate beating of the heart. Those individuals with heart conditions caused by a virus only undergo “flu-like symptoms.” By doing any tests, it results in a diagnosis, works together with the physician related to the plan of action or treatment. Important to detect and keep a check on the symptoms and take the medicines on time as prescribed by the doctor with the life-style modifications and remedies.

References

  1. http://www.eurekaselect.com/69096/article
  2. https://link.springer.com/article/10.1007%2Fs10741-018-9688-x
  3. https://www.mayoclinicproceedings.org/article/S0025-6196(11)60670-8/fulltext

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