Treatment

In many people, myocarditis improves on its own or with treatment, leading to a complete recovery. Myocarditis treatment focuses on the cause and the symptoms, such as heart failure.

Medications

People with mild myocarditis may only need rest and medication.

• Corticosteroids. Certain rare types of viral myocarditis, such as giant cell and eosinophilic myocarditis, may improve with corticosteroids or other medications to suppress your immune system.

• Heart medications. If myocarditis is causing heart failure or arrhythmias, you may need to stay in the hospital. Your doctor will prescribe drugs or other treatments, depending on your signs and symptoms. For example, if you have certain abnormal heart rhythms or severe heart failure, you may be given medications to reduce the risk of blood clots forming in your heart.

  If your heart is weak, your doctor might prescribe blood pressure medications to reduce the strain on your heart or help your body remove excess fluid. These medications may include diuretics, beta blockers, angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs).

• Medications to treat chronic conditions. If myocarditis is caused by a chronic illnesses, such as lupus, treatment is directed at the underlying disease.

Surgeries and procedures

If you have severe myocarditis, you will need aggressive treatment, which might include:

• IV medications. Medications given through a vein are used to quickly improve your heart's ability to pump.
• Ventricular assist devices (VAD). A VAD is a device that helps pump blood from the lower chambers of your heart (the ventricles) to the rest of your body. VADs are used in people who have weakened hearts or heart failure. This treatment may be used to allow your heart to recover or while you're waiting for other treatments, such as a heart transplant.
• Intra-aortic balloon pump. The doctor inserts a thin tube (catheter) into a blood vessel in your leg and guides it to your heart using X-ray imaging. A balloon attached to the end of the catheter inflates and deflates in the main artery leading out to the body from the heart (aorta). An intra-aortic pump helps increase blood flow and decrease the strain on your heart.

• Extracorporeal membrane oxygenation (ECMO). An ECHO machine mimics the function of the lungs. It removes carbon dioxide and adds oxygen to the blood. If you have severe heart failure, this device can provide oxygen to your body. During ECMO, blood is removed from the body, passed through the ECMO machine and then returned to the body.

  The ECMO machine takes over the work of your heart. This treatment may be used to allow the heart to recover or while waiting for other treatments, such as a heart transplant.

• Heart transplant. If you have very severe myocarditis, your doctor might recommend urgent heart transplantation.

Some people with myocarditis might have chronic and irreversible damage to the heart muscle requiring lifelong medications, while other people need medications for just a few months and then recover completely. Either way, your doctor is likely to recommend regular follow-up appointments, including tests to evaluate your condition.