Myocarditis

Treatment

Mayo Clinic doctors with training in heart disease (cardiologists), surgeons and other specialists work closely to evaluate people who have myocarditis and develop the most appropriate treatment plan.

Treatment of your myocarditis depends on the cause and severity of your condition.

Treatment usually involves:

• Controlling or treating the underlying cause of the inflammation
• Reducing the workload on your heart
• Treating heart abnormalities caused by the inflammation
• Medications. If you have mild viral myocarditis, you can usually rest at home, take medications and follow up with your doctor.
  • ACE inhibitors. ACE inhibitors lower blood pressure, improve blood flow and decrease your heart's workload. These drugs also blunt some effects of hormones that promote salt and water retention. Your doctor may prescribe them to treat an enlarged heart or symptoms of heart failure.
  • Beta blockers. Beta blockers slow your heart rate, lower blood pressure and lessen the risk of some abnormal heart rhythms.
  • Steroids. These drugs modify the immune system and can reduce inflammation in select people.
  • Diuretics. Diuretics reduce the workload on your heart and reduce excess fluid in your body.
  • Other medications. Some people need medications to control abnormal heart rhythms. Others may need blood-thinning medication if a blood clot is present in their heart.
• Pacemaker or internal cardioverter defibrillator (ICD). If you have abnormal heart rhythms (arrhythmias), you may be a candidate for a pacemaker or ICD, devices that help regulate heart rate.

If you have severe damage to your heart, or heart failure or cardiac arrhythmias due to myocarditis, you may need:

• Monitoring and treatment. If you have severe damage to your heart, you may need care in a hospital. After treatment, you may need to limit your activities and take medications for the rest of your life.
• Heart transplant. If you have very severe myocarditis, you may need a heart transplant.
• Ventricular assist device. (VAD). In some people whose myocarditis has caused severe heart failure, your doctor may implant a ventricular assist device ("artificial heart") with the hope that your heart will recover. In this case, the VAD may act as a "bridge to recovery," and your doctor will sometimes remove it after your heart recovers. Doctors also may offer a VAD as a long-term treatment for some people who have heart failure.