Heart muscle inflammation
Inflammation of the heart muscle (myocarditis) is not a rare illness and may be caused by a viral or bacterial infection as well as myocardial involvement in rheumatic diseases. Most heart muscle inflammations respond well to treatment and heal completely without incident.
Some cases, however, take a severe or chronic course. In an acute case, life-threatening heart rhythm disturbances can occur. Chronic progressions tend to result in varying degrees of scar formation. This can lead to heart muscle weakness and ultimately to heart failure.
The treatment of heart muscle inflammation requires strict physical inactivity. Stress can negatively affect its progression or lead to sudden heart death. Undiagnosed heart muscle inflammations are one of the leading causes of death among athletes.
The diagnosis of a myocarditis is difficult and was, until recently, only reliably detectable in severe progressive forms. In such cases, suspicions are confirmed via a heart catheterisation with a tissue biopsy from the heart muscle. This procedure is high risk and not very accurate, as the tissue biopsy comes from small areas of the heart which do not necessarily have to be affected by the inflammation. In the event of myocarditis, other diagnostic procedures, such as blood tests, electrocardiogram (ECG), and heart ultrasound (echocardiography) show uncharacteristic changes that also arise in many other illnesses.
The heart MRI now offers an accurate procedure for the diagnosis of myocarditis, because it can pictorially depict tissue characteristics of the heart muscle. In addition to information about the anatomy and function of the heart, typical features of an inflammation can be directly imaged. These include an elevated concentration of tissue fluid, an increased blood circulation at rest and vessel permeability as well as the breakdown of muscle cells and their replacement by small islands of scar tissue. By combining this information, the diagnosis of an inflammation can be made, and, at the same time, the severity level and the stage can be assessed. Since MRI represents a harmless examination procedure when all safety precautions are followed, the method can also be used to monitor progress in heart muscle inflammations.
