Treatment Options for Severe Myocarditis

Myocarditis can be categorized into mild and severe forms, with similar treatment approaches. The following outlines the primary therapeutic strategies for managing severe myocarditis:

Rest as a Foundational Treatment

Complete bed rest is crucial for patients with myocarditis, regardless of severity. For those with severe cases, prolonged rest is especially important to prevent additional strain on the heart. Many patients experience significant heart failure and even enlarged heart chambers, making it essential to rest for extended periods—often between three to six months.

Antiviral and Antiarrhythmic Therapy

Since most cases of severe myocarditis are caused by viral infections, antiviral medications play a key role in treatment. These drugs help combat the underlying infection and reduce inflammation in the heart muscle. Additionally, arrhythmias are common in severe myocarditis patients. To manage these irregular heartbeats, antiarrhythmic drugs may be prescribed to stabilize heart rhythm and prevent complications.

Management of Heart Failure and Advanced Support

Severe myocarditis often leads to pronounced heart failure due to a significant decline in the heart's pumping ability. Alongside standard treatments such as inotropic and diuretic therapy, mechanical circulatory support may be required in critical cases. Options include extracorporeal membrane oxygenation (ECMO), intra-aortic balloon pumps, and other assistive devices that help maintain heart function and improve outcomes.