likelihood of developing myocarditis

[cardiophobiac]

Hi,

I was wondering if anyone can shed some light on their knowledge of heart virus myocarditis. I am so anxiety and fear riddled with the thought of developing a common cold/virus and it leading on to myocarditis. I believe the reason it affects me this much is down to the fact i enjoy a workout, and dont like leaving it too long before returning after being unwell. I know it could mean that i fall in the category of higher risk due to that. Just how worried should i be about this? I can find no proper statistical data on the prevalence of it.

[2210485]

Oh and yeah any problems,with the leaflets are easily visible

[2210485]

Ok.. Concrete.. So beginning with causes:

Infectious causes of myocarditis

Viral
Adenovirus, Arbovirus, Arenavirus, Coxsackie virus, Epstein–Barr virus, Cytomegalovirus, Echovirus, Encephalomyocarditis virus, Hepatitis B, Human Herpes virus 6, Human immunodeficiency virus-1, Influenza virus B, Mumps virus, Parvovirus B19, Poliomyelitis virus, Rabies, Respiratory syncytial virus, Rubella virus, Rubeola virus, Vaccinia virus, Varicella virus, Variola virus

Bacterial
Brucellosis, Clostridia, Diphtheria, Francisella, Gonococcus, Haemophilus, Legionella, Meningococcus, Mycobacterium, Mycoplasma, Pneumococcus, Psittacosis, Salmonella, Staphylococcus, Streptococcus, Tropheryma whippleii

Fungal
Actinomyces, Aspergillus, Blastomyces, Candida, Coccidioides, Cryptococcus, Histoplasma, Nocardia, Sporothrix
Rickettsial
Rocky Mountain spotted fever, Q fever, Scrub typhus, Typhus
Spirochetal
Borrelia, Leptospira, Syphilis
Helminthic
Cysticercus, Echinococcus, Schistosoma, Toxocara, Trichinella
Protozoal
Entamoeba, Leishmania, Trypanosoma, Toxoplasmosis
European Heart Journal
Oxford University Press
Acute viral myocarditis
Robert Dennert, Harry J. Crijns, and Stephane Heymans"

Basically to summarize that list.. Every illness a human being could reasonably expect to come into contact with..

Viral myocarditis is primarily the result of an inflammatory/autoimmune response. We know very little about it.

Bacterial myocarditis follows a severe bacterial infection.. The kind that puts you in the icu.

Your primary concern is viral myocarditis.

Globally myocarditis effects approximately 22 out of every 100,000 patients.

Developed countries suffer a lower, though unspecified burden from literature i found.

This likely is due to the prevelance of vaccinations and antibiotics.

Specific findings based off autopsy reports related to the evidence of viral myocarditis puts the prevelence at roughly .0007% of the population.

Thats roughly 25,000 that will americans will develop viral myocarditis in their lifetimes, out of which 56% actually die as a result.

To put that into perspective based off the sources of available the chance of contracting viral myocarditis in your lifetime is the equivilent of buying 1 songle powerball ticket, for every drawing for ones entire life... For reference we all know someone who does this im sure, and we can all grasp how realistically likely that is to actually succeed.

Your risk of being killed in a car accident in your lifetime is 23 times higher.

Now.. That said.. The risk is real.. Its there

[cardiophobiac]

Thanks for all of that lol!. A big, good bit of information there. I never realised the amount of potential triggers for it to be honest. It's crazy. I suppose the difficult part is that 90% or more of us have antibodies for most of the viruses that cause it anyway, so who knows if its actually the virus that causes it. So, if I'm right there's approx 6 or 7 billion people in u.s as of 2017, and only 25000 of them will develop viral myocarditis. I'll have to work out the percentage on that lol. Must be extremely minimal. The last bit you wrote about the Powerball, your right, I don't personally know of anybody that has won the lottery, but I know of 2 couples within 25 miles from me that have been in the local paper for winning. I guess the problem I have is dealing with that percentage value. Just because someone I know develops myocarditis, doesn't make my risk any lower, does it?

[2210485]

The steriotypical finding would be the oddly shaped mv leafelets.. Very domed, but minimal regurg usually, perhaps some abnormalities in leaflet motion as well.

As for the 2 bird with 1 stone thing.. You really only kill 1.

Stress echo is just a bit more ssensitive and specific then a simple stress test.

We only get 4 images in the stress echo for pre and post and we only look at wall motion.. Thers no velocities or shunt determinations etc etc. No other calculations. This of course is because by the time we got all that your hr would go down.

Despite only being 4 images it usually requires the attention of the most senior tech.. And often requires contrast.. This is because the images have to be taken immediately after exercise.. Within seconds... Theres cant be a delay.

If you choose to do a more specific stress echo vs just looking at ecg, for all patients.. EVEN low risk patients.. Then youve just successfully taken your most experienced echo tech away from being able to assess heart failure patients, or doing tees for cardioversions in the icu, or echoing patients with tamppnade or effusions in the cath lab... Now they only,have time for stress echo.. Forever.

[cardiophobiac]

as for them domed shape leaflets, i take it they would be easily visible through the scan? as for the stress echo i understand. I suppose i 'hoped' there would be enough technicians with the knowledge of such available. The odd thing is i find mixed responses about myocarditis inflammation from physicians, cardiologist, practitioners etc. I believe all BUT cardiologists down play it a bit. Maybe its because they dont see many people with it, or perhaps mistake it for pericarditis. I came across a post on social media today of a sunderland premier player who had time off due to myocarditis, and has to retire now. I would love to relax myself about it with cold hard facts .... ei ... most prevalent age ... most prevalent countries it occurs ... and weather exercising with a cold or flu really does increase your risk

[2210485]

They wont give you a stress echo.. Not unless you have increased symptoms such as chest pain or shortness of breath with exercise.. Too much staff, money, risk, time etc.

100% guarantee they wont do a stress echo without a good reason.

A regular, good ole fashioned non stress echo should give you all the information you need and is easily something a doctor will consider to put your fears to rest.

Just tell him you had strep and wanna check your mitral and he shouldnt have any qualms.

[cardiophobiac]

Really! I never thought of it that way. I just presumed it would cut costs as you'd be killing two birds with one stone (echo + treadmill ECG at the same appointment). I know that it can be handy for showing how well blood flow is during exercise, probably more useful to someone with CAD risks I suppose. Trace regurgitation is something I've read about on the mitral valve. would that be indicative of a strep infection that's perhaps spread or would it be more pronounced.

[2210485]

Oh and p.s.

Prior post strep rheumatic fever at any point in life can be diagnosed by echo (ultrasound) visualization of the mitral valve. Bowed/tented, distorted or prolapsed mitral valves could indicate a prior post strep complication.

Your endocarditis risk can also be evaluated on echo in part by looking at the aortic valve. If youre part of the minority born with a bicuspid ao youd have a higher risk.

Ultrasound can also help rule out any ongoing pericarditis or endocarditis by looking for calcium deposits on leaflets and fluid around the heart.

Sooo.. If youre superrrrr worried about it. You can just request that ultrasound

[cardiophobiac]

Thanks for the reply again mate. i have a cardiologist app in January to discuss some things anyway. I believe they are going to routinely do an ecg but i am planning on asking for a stress echo. i suppose theres not anything that would lead me to believe i have it symptoms wise, except sometimes a pvc or pac period at times. I have done too much reading on mr google and now have read many storys on athletes or sportsman collapsing post exercise and autopsy shows inflammation on the heart.(Although it is alot more common to see HOCM or ARVC cauing these deaths, theres still some out there). I guess my overthinking process wonders off sometimes. I just cannot possibly in this world see how somebody with a heart inflammation can show no symptoms that would suggest the heart.

[cardiophobiac]

Hey, I noticed you've answered both my posts, thank you my friend it's nice of someone to take the time to answer them. No I haven't ever developed it, however the fear of it started a few years back with strep throat, I was very unwell in hospital for 3 nights and they said to me when I left not to return to exercise for a week or so due to a small risk of a heart infection. I didn't develop any of the symptoms of any of the infections in that area but it still stuck with me and haunts me to this day. I then learned myocarditis is usually, in this country, a result of a common cold virus. And some people can show only viral symptoms not heart symptoms like you'd expect

[2210485]

Yeah.. Strep causes a number of heart problems in folks, most of them minor.

1. Strep that is treated with antibiotics doesn't cause heart problems. If you took medicine your chance is non existent, seriously you have no elevated risk.

2. Endocarditis and rheumatic fever are still significantly more likely post strep then full blown myocarditis.

Comparing endocarditis to myocarditis is kind of like comparing the cold to the flu. They can both yield similar symptoms, but 1,is definitately more concerning.

[2210485]

Myocarditis? Thats pretty serious and usually not the first issue youll have. Were you diagnosed with this in the past?

Pericarditis is much more common and typically resolves on its own..

Endocarditis is a little less common then pericarditis but is also a risk you can face.. However it usually comes about as the result of a serious bacterial infection, and can be complicated by certain risk factors as a bicuspid aortic valve. This is seen, especially in older more vulnerable populations..

For a young lad like you uncomplicated pericarditis is by far the most likely to result from a common illness.

If you were diagnosed with myocarditis id be very intdrested in hearing your story and some of your demographics, age, gender, history.. etc.