12th March 2024

Management

Treatment is symptomatic with hemodynamically stable patients with myocarditis-induced heart failure managed with beta-blockers, angiotensin- converting enzyme inhibitors and diuretics. Specific antiviral agents are available based on the EMB viral PCR results, but these should be given after seeking specialist advice from the microbiology team. 

Patients with signs of heart failure with haemodynamic instability are managed in a high-dependence critical care setting where cardiovascular support can be provided and workup initiated for potential cardiac transplantation. 

Patients should avoid excessive physical activity for six months following myocarditis. This advice is the same for athletes and non-athletes. 

Clinical outcomes in myocarditis remain highly variable. Up to half of patients with acute myocarditis show a resolution of their symptoms within the first few weeks. However, up to 25% of patients will deteriorate further and either die as a result or progress to severe dilated cardiomyopathy.