endocarditis, myocarditis and pericarditis. Pericarditis may lead to fluid buildup around the heart (cardiac tamponade), which is drained in a procedure called pericardiocentesis.
Virtually any virus can cause myocarditis, but the most common are enteroviruses, influenza (flu) virus, and the common viruses of childhood, such as rubeola (which causes measles) and varicella (which causes chickenpox). Other causes include bacterial infections such as Lyme disease, toxins such as cocaine, and autoimmune diseases (diseases in which the body's disease-fighting immune system attacks the body's own tissues) such as lupus. In most cases, no definitive cause is found, and the agent responsible is presumed to be a virus.
Most cases of viral myocarditis are mild or asymptomatic (without symptoms) and the condition is never suspected. Usually, there is some damage to the heart muscle, which can cause enlargement of the heart, shortness of breath, and heart palpitations and arrhythmias (irregular heart rhythms). Sometimes, the non-cardiac manifestations of the viral infection -- such as rash, fever and sore throat -- are most prominent. Chest pain, when present, can make it difficult to distinguish myocarditis from a heart attack.
The most distressing thing about viral myocarditis is whom it strikes. Most patients have had no significant previous illness and may be in the prime of life. Then, without warning, heart failure develops.
Definitive diagnosis can be made by biopsy (removal of a small piece of tissue for examination) of the inside lining of the heart. This procedure is performed by inserting a catheter (a flexible tube) into a blood vessel in the groin and pushing it along until it reaches the heart.
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