What are the other Names for this Condition? (Also known as/Synonyms)

• Myocarditis, Autoimmune type

What is Autoimmune Myocarditis? (Definition/Background Information)

• Autoimmune Myocarditis is a heart condition caused by the malfunctioning of the immune system that produces antibodies, which attacks one’s own heart. This leads to a set of heart-associated symptoms
• Autoimmune Myocarditis is brought about by the presence of certain autoimmune disorders including sarcoidosis, scleroderma, and Kawasaki disease. The condition is seen in individuals of any age
• This cardiac condition may result in chest pain, breathing issues, and congestive heart failure. It may result in complications that include arrhythmias or buildup of fluid around the heart (pericardial effusion)
• The diagnosis of Autoimmune Myocarditis may require a thorough physical checkup by the healthcare provider, blood tests, imaging studies of the heart, and an endomyocardial biopsy, if needed. Additional tests may be necessary to diagnose the underlying autoimmune disorder
• The treatment of Autoimmune Myocarditis includes steroid therapy, management of arrhythmias using anti-arrhythmic medication, and immunotherapy. Treating the underlying autoimmune disorder is also important and is undertaken
• With timely recognition of the condition and adequate treatment, the prognosis of Autoimmune Myocarditis is good. However, a delayed diagnosis and/or treatment may result in long-term damage of the heart

Who gets Autoimmune Myocarditis? (Age and Sex Distribution)

• Children and adults may be at risk for Autoimmune Myocarditis
• Both males and females are affected
• There is no known racial, ethnic, or geographical preference

What are the Risk Factors for Autoimmune Myocarditis? (Predisposing Factors)

The risk factors for Autoimmune Myocarditis may include the following conditions:

• Scleroderma
• Systemic lupus erythematosus (SLE)
• Sarcoidosis
• Eosinophilic granulomatosis with polyangiitis
• Kawasaki disease

Even though several members of a family may be occasionally affected by myocarditis, a positive family history for this heart condition is not yet reported.

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Autoimmune Myocarditis? (Etiology)

Autoimmune Myocarditis is caused by the dysregulation of an individual’s own immune system. The immune system creates antibodies that adversely affects the heart and heart muscles (attacks the body’s own cells), resulting in a set of associated symptoms.

This may occur due to the following autoimmune disorders:

• Scleroderma
• Systemic lupus erythematosus (SLE)
• Sarcoidosis
• Eosinophilic granulomatosis with polyangiitis
• Kawasaki disease

What are the Sign and Symptoms of Autoimmune Myocarditis?

The signs and symptoms of Autoimmune Myocarditis vary from one individual to another; it may be mild in some and severe in others. In many cases, a sudden onset of the symptoms may be noted.

Following are some of the common signs and symptoms noted:

• Chest pain and discomfort; acute chest pain can mimic heart attack
• Fatigue
• Decreased ability to exercise, or decreased exercise tolerance
• Palpitations; abnormal heart beats
• Heart rhythm abnormalities (arrhythmias)
• If the individual has congestive heart failure, then it can result in shortness of breath, tiredness, and swelling of the extremities

There may be other symptoms related to the underlying systemic disorder.

How is Autoimmune Myocarditis Diagnosed?

A healthcare provider may use some of the following methods to diagnose Autoimmune Myocarditis:

• A complete physical examination and a thorough medical history
• Examination of the heart
• Blood tests that include:
  • Calcium test and vitamin D blood level test
  • Angiotensin-converting enzyme blood test
  • Erythrocyte sedimentation rate (ESR) test
  • C-reactive protein levels in blood
  • Cardiac enzyme panel test; tests for cardiac enzymes
• Imaging studies that include:
  • Chest X-ray
  • Doppler ultrasound: Sound waves are used to measure the speed and direction of blood flow
  • CT scan of the heart
  • Contrast-enhanced MRI scan of heart
  • Positron emission tomography (PET) scan
• Electrocardiogram (ECG): It is used to measure the electrical activity of the heart, in case of arrhythmias
• Specific test and imaging scans to diagnose any underlying autoimmune disease
• Endomyocardial biopsy: A tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

A differential diagnosis may be undertaken to eliminate the following heart conditions prior to arriving at a definitive diagnosis of Autoimmune Myocarditis:

• Cardiac sarcoidosis
• Giant cell myocarditis
• Lymphocytic myocarditis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Autoimmune Myocarditis?

Some potential complications of Autoimmune Myocarditis include:

• Abnormal heart rhythms and conduction disorders
• Inflammation of the sac surrounding the heart (called pericarditis) and collection of fluid around the heart (called pericardial effusion)
• Partial or complete heart block due to scarring of heart tissue
• Complications arising from the presence of an underlying autoimmune condition

How is Autoimmune Myocarditis Treated?

Autoimmune Myocarditis may be treated through the following measures:

• Steroid therapy; prescription of anti-inflammatory drugs, in severe cases
• For those with arrhythmias, anti-arrhythmic medication may be administered
• Immunosuppressive therapy
• Pacemaker and defibrillator implantation
• Pericardiocentesis (removal of fluid from pericardial sac) may be performed in case of pericardial effusion
• Undertaking treatment of underlying autoimmune conditions
• Periodic monitoring or follow-up of the condition with the healthcare provider is recommended

How can Autoimmune Myocarditis be Prevented?

• Presently, there are no definitive preventative measures available for Autoimmune Myocarditis
• Early diagnosis and treatment of the underlying autoimmune disorder may help prevent Autoimmune Myocarditis and other complications from arising in the affected individual

What is the Prognosis of Autoimmune Myocarditis? (Outcomes/Resolutions)

The prognosis of Autoimmune Myocarditis depends upon the underlying cause (autoimmune disorder) and the severity of the signs and symptoms.

• In many cases, it is good with early and appropriate treatment
• If the diagnosis and/or treatment is delayed, it can result in severe heart-related complications

Additional and Relevant Useful Information for Autoimmune Myocarditis:

The following article link will help you understand other heart conditions:

http://www.dovemed.com/healthy-living/heart-center/