Myocarditis During Pregnancy: Don't Panic, Timely Treatment Ensures Health

Case Overview

Patient: Female, 31 years old

Condition: Myocarditis

Hospital: First Affiliated Hospital of Xi'an Jiaotong University

Visit Date: December 2018

Treatment: Herbal and supportive medication (Astragalus granules, Vitamin C tablets, Coenzyme Q10 tablets)

Treatment Duration: 4 weeks of hospitalization followed by 6 months of outpatient follow-up

Outcome: Full recovery from myocarditis, normal fetal development

Initial Presentation

The patient, a 31-year-old woman, came to the clinic due to intermittent chest tightness and palpitations that had persisted for two days. She also experienced discomfort in her upper back, which lasted for over 10 hours before subsiding. Given that she was in her second trimester, she was naturally concerned about the health of her unborn child. Upon physical examination, doctors noted a low heart sound, a heart rate of 96 beats per minute, and a grade 2/6 systolic murmur at the pulmonary valve area. Further tests, including an ECG, showed sinus tachycardia. Blood work revealed elevated white blood cell count and neutrophil percentage, while cardiac biomarkers such as troponin and creatine kinase-MB were also high. An echocardiogram confirmed findings consistent with myocarditis, leading to hospital admission for treatment.

Treatment Plan and Progress

During hospitalization, it was confirmed that the patient was 25 weeks pregnant, with normal fetal heart rate and movement. Viral serology tests indicated a recent viral infection, which likely triggered the myocarditis. After a detailed discussion with the patient and her family about the importance of timely treatment during pregnancy, they agreed to proceed with medication. The treatment plan included Astragalus granules for antiviral effects, along with Vitamin C and Coenzyme Q10 to support heart function and immunity. Fetal heart monitoring was performed continuously throughout the treatment to ensure the baby's well-being.

Positive Response to Therapy

After one week of in-hospital treatment, follow-up tests showed a significant decrease in inflammatory markers and cardiac enzymes, indicating a positive response to the prescribed therapy. There were no complications during the treatment period, and fetal monitoring remained stable with normal development observed via ultrasound. Based on the patient's condition and personal preference, she was discharged with instructions to continue the same medication regimen for three more weeks. A follow-up visit three weeks later revealed normal ECG, cardiac enzyme levels, and echocardiogram results, confirming full recovery from myocarditis.

Post-Recovery Care and Recommendations

At the follow-up appointment, the patient expressed relief and gratitude for the successful outcome. She was advised to maintain a strong immune system through proper lifestyle habits. Since her myocarditis was linked to a viral infection, she was encouraged to take preventive measures such as dressing appropriately for the weather, avoiding crowded places during flu season, and engaging in light physical activities like walking or prenatal yoga under family supervision. Additionally, she was advised to maintain a nutrient-rich diet, including fresh fruits high in vitamin C to further boost immunity, especially during pregnancy.

Clinical Insights and Final Thoughts

Myocarditis often develops 1 to 3 weeks after a viral infection and may present with non-specific symptoms like fatigue, chest discomfort, and palpitations. Since there is no specific cure, early diagnosis and supportive care are crucial. Delayed treatment can lead to severe complications, particularly during pregnancy, where both maternal and fetal health are at risk. In this case, timely intervention and the patient's good baseline health contributed to a favorable outcome. However, ongoing vigilance and preventive care remain essential to avoid recurrence and ensure long-term well-being.