Myocarditis and Pericarditis: Understanding the Differences, Causes, Symptoms, and Diagnosis

By SWA

Myocarditis and pericarditis are two distinct inflammatory conditions affecting different parts of the heart. Understanding their differences, causes, symptoms, and diagnostic approaches is crucial for timely and effective management.

What are Myocarditis and Pericarditis?

Myocarditis refers to inflammation of the myocardium, the heart muscle responsible for contracting and pumping blood. Pericarditis, on the other hand, is inflammation of the pericardium, the sac-like tissue layer that surrounds and protects the heart.

What Can Myocarditis Be Confused With?

Myocarditis often shares symptoms with other heart conditions, leading to potential misdiagnosis. For instance:

  • Heart Failure: Both conditions can cause fatigue, shortness of breath, exercise intolerance, and difficulty breathing while lying down.
  • Heart Attack: Myocarditis can present with chest pain and fatigue similar to a heart attack, making it challenging to distinguish between the two without further testing.

Causes

The causes of myocarditis and pericarditis can be varied and include:

  • Infections: Viral (e.g., Coxsackievirus), bacterial (e.g., tuberculosis), fungal, and protozoal infections.
  • Postpericardiotomy Syndrome (Dressler's Syndrome): Occurs in a small number of patients following heart surgery.
  • Rheumatologic Diseases: Conditions such as systemic lupus erythematosus, rheumatoid arthritis, and rheumatic fever can lead to these inflammatory heart conditions.
  • Several potential links and interactions between von Willebrand factor (VWF) and myocarditis/pericarditis. Both conditions involve inflammatory processes that affect endothelial cells, leading to increased VWF release from these cells and platelets as part of the body's response to vascular injury. 
  • While cortisol, ACTH, and aldosterone do not directly cause myocarditis and pericarditis, they can influence the development and progression of these conditions through their roles in stress response, immune function, inflammation, and cardiovascular regulation.

For more information on causes, refer to Boston Children's Hospital.

Symptoms

The symptoms of myocarditis and pericarditis can overlap but also have distinctive characteristics:

  • Myocarditis: Common symptoms include chest pain, fatigue, shortness of breath, and arrhythmias (irregular heartbeats). Notably, chest pain may worsen when lying down and improve when leaning forward if the inflammation affects the pericardium.
  • Pericarditis: Besides chest pain, which can radiate to the neck, shoulders, or back, symptoms may include fever, cough, and arthralgia (joint pain). Pericarditis may also lead to cardiac tamponade, a life-threatening condition characterized by breathlessness, dysphagia (difficulty swallowing), cough, and hoarseness.

Detailed symptom information can be found at Medical News Today.

Diagnosis

Diagnosing myocarditis and pericarditis involves various tests:

  • Cardiac MRI: Provides detailed images to assess inflammation in the heart.
  • Cardiac Catheterization: The gold standard for diagnosing myocarditis involves obtaining a heart muscle sample and examining it under a microscope.

For more on diagnostic approaches, visit Lurie Children's Hospital.

Conclusion

Recognizing and distinguishing myocarditis and pericarditis is vital for appropriate treatment. Both conditions share common symptoms with other heart diseases, but careful examination and specific diagnostic tests can aid in accurate diagnosis and management.

For further reading and resources, explore the provided links:

© 2000-2025 Sieglinde W. Alexander.
All writings by Sieglinde W. Alexander have a fifty-year copyright.
Library of Congress Card Number: LCN 00-192742
ISBN: 0-9703195-0-9

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