What Happens If Myocarditis Becomes Severe?

Myocarditis, often referring to viral myocarditis, can be triggered by common viruses such as those causing colds or diarrhea. In severe cases, it can be life-threatening. Initially, patients may experience symptoms like palpitations or chest tightness. As the condition progresses, it can lead to heart failure, characterized by shortness of breath during physical activity.

Potential Complications of Severe Myocarditis

One of the serious complications of myocarditis is hypotensive shock, where blood pressure drops dangerously low. This can impair blood flow to vital organs. Additionally, arrhythmias—such as ventricular premature beats, ventricular tachycardia, and even ventricular fibrillation—can occur, increasing the risk of sudden cardiac arrest.

Heart Block and the Need for Temporary Pacing

Some patients may develop second- or third-degree atrioventricular block, a condition where the electrical signals between the heart's chambers are disrupted. In such cases, a temporary pacemaker may be necessary to regulate heart rhythm until the inflammation subsides and normal conduction resumes.

Understanding Fulminant Myocarditis

The most severe form of this condition is fulminant myocarditis, which can rapidly lead to circulatory collapse. Patients often experience profound hypotension, cold and clammy extremities, reduced urine output, and signs of multi-organ dysfunction due to poor peripheral perfusion.

In the most critical cases, patients can deteriorate quickly and face a high risk of mortality. However, timely intervention with advanced life support measures, such as extracorporeal membrane oxygenation (ECMO), can significantly improve outcomes. With ECMO support, many patients begin to recover cardiac function within two to three weeks.