Myocarditis doesn’t always cause warning signs and symptoms until it becomes quite advanced. If the symptoms occur, they’re usually mild (this is especially true for a mild, uncomplicated myocarditis). The most common ones are shortness of breath and chest pain. But does the disease also cause back pain?
The muscular wall of the heart (heart muscle) is called myocardium. It plays a key role to keep your heart working normally. It relaxes to allow the heart refills with blood, and it contracts to push blood out of the heart. Myocarditis is inflammation affecting this myocardium, as the name suggests.
When the heart muscle becomes inflamed, this can affect the heart performance – which could be fatal if the problem doesn’t relieve. Without prompt treatment, swelling and cell damage associated with myocarditis may get worse over time. In severe cases, a number of complications may occur, some are as follows:
- Arrhythmias, abnormal-rapid heartbeats. Severe inflammation of the heart muscle can significantly affect the heart performance, making the heart work harder and you experience arrhythmias.
- Heart failure. Inflammation of myocardium may worsen without treatment. Over time, this may cause varying degrees of heart failure. In severe situations, a ventricular assist device or even a heart transplant is required.
- The risk of developing serious blood clots. If the heart doesn’t pump blood normally, it’s easier for the blood to pool in the heart, leading to blood clots. If a blood clot forms in one of the heart’s arteries, this may cause a heart attack. Stroke may also occur if the blood clots form in the blood vessels that carry blood to the brain.
- A life-threatening, sudden cardiac death. Rarely, myocarditis-related arrhythmias turn into serious and cause the heart to suddenly stop working (beating).
What causes the disease is not always identifiable. But in many cases, it’s associated with the following factors /conditions:
- An infectious cause. There are many infections associated with myocarditis. The common ones include viral infections (such as HIV, Epstein-Barr virus, human herpes virus, chickenpox /varicella, and adenovirus), bacterial infections (such as streptococcus, staphylococcus, and borrelia burgdorferi that causes Lyme disease), and parasites (for example trypanosoma cruzi, a parasite that causes Chaga’s disease).
- Toxic, chemical substances such as arsenic, hydrocarbon, radiation, and overuse of alcohol.
- Certain medications such as some anti-seizure medications, illegal substances, and some cancer medications (for example, doxorubicin).
- Certain medical conditions, such as chronic inflammatory diseases (rheumatoid arthritis, lupus, and sarcoidosis).
Since myocarditis can resemble many other health conditions, it is not always easy to diagnose. Therefore along with physical examination, a number of other tests are usually required to make correct diagnosis – these include:
- ECG (electrocardiogram) to evaluate your heart function, rhythm, and size. It may be used with echocardiogram, a procedure to help analyze your heart wall motion.
- Sometimes blood tests and imaging tests are required. Blood tests to identify infection and inflammation. Imaging tests, chest X-ray or MRI for example, to provide detailed pictures of the heart and its structure.
- Endomyocardial biopsy, a procedure in which a catheter (small tube) is inserted into the chest area through a vein in the neck. If necessary, a small sample of the myocardium’s tissue is removed so it can be closely analyzed it in the lab to look for infection or inflammation.
A mild case of the disease is more likely to not cause any symptom. Even many people with uncomplicated myocarditis never even know they had it – sometimes it may improve on its own without treatment.
In severe cases, the disease may also not be diagnosed until signs and symptoms of heart failure begin to develop. Interestingly, these cases can sometimes relieve without medical intervention. But to get a complete recovery, treatment is necessary since severe myocarditis is more likely to cause irreversible damage to the heart.
To prevent the serious complications of the disease, early diagnosis is important including for the mild ones. So what are the common symptoms of myocarditis? How about back pain?
Back pain can affect anyone, including people with heart problems. The good news, it’s mostly linked to minor problems which usually relieve with lifestyle measures (see also a few effective remedies for back pain relief in this section). However sometimes it can be serious or linked to particular health conditions.
In general, myocarditis has nothing to do with back pain. The common symptoms of the disease include shortness of breath, chest pain, heart palpitations, fatigue, fluid retention (swelling in the legs, ankles, or feet), and symptoms of a viral infection (fever, body aches, sore throat, and headache).
But it’s also possible for people with myocarditis to experience back pain with one or some of the following factors: