Treatment Approaches for Myocarditis

Myocarditis treatment depends on the underlying cause, with viral myocarditis being one of the most commonly diagnosed types in clinical settings. In addition to antiviral therapy, the primary treatment strategies include rest, symptomatic relief, and supportive care.

Understanding Myocarditis from a Traditional Chinese Medicine (TCM) Perspective

Traditional Chinese Medicine does not specifically identify "viral myocarditis" as a condition. However, based on its clinical manifestations and progression patterns, it can be categorized under the TCM condition known as "Xin Dan" or "Heart Heat Disease." This condition typically arises from external pathogens, such as heat-toxin or infections following trauma or surgery, which invade the heart and damage cardiac muscle and inner tissues. The main symptoms include fever and palpitations, aligning with internal heat disorders in TCM theory.

Stages of TCM Treatment for Myocarditis

TCM treatment for myocarditis is generally divided into acute and chronic phases, with treatment strategies tailored to individual syndromes.

Acute Phase Treatment

During the acute stage, if symptoms are caused by wind-heat invading the lungs and disturbing the heart, the therapeutic approach should focus on relieving the exterior, clearing heat, detoxifying, and calming the heart. A modified Yin Qiao San formula is often used in such cases.

If the condition progresses to pathogenic toxins affecting the heart along with deficiency of both Qi and Yin, the treatment should emphasize clearing heat, detoxifying, nourishing Yin, and boosting Qi. A combination of Qing Xin Lian Zi Yin and Sheng Mai San, adjusted as needed, is commonly prescribed.

In severe cases where Yang deficiency leads to Qi collapse, treatment should aim to restore Yang, reverse collapse, and stabilize Qi. A modified Shen Fu Long Mu Tang is typically recommended.

Chronic Phase Treatment

For the chronic phase, treatment continues to be syndrome-specific, focusing on restoring balance and strengthening heart function through herbal therapy and lifestyle adjustments.

Supportive and Symptomatic Care

Supportive therapy focuses on managing clinical symptoms. Patients with mild or no symptoms often recover within about a week with adequate rest and reduced physical exertion. Symptomatic treatments may include managing fever, fatigue, muscle pain associated with upper respiratory infections, or gastrointestinal symptoms like nausea, vomiting, and diarrhea.

Management of Severe Cardiac Symptoms

Patients presenting with significant cardiac symptoms usually require hospitalization. Treatment is tailored to their specific condition and may include antiarrhythmic therapy or heart failure management. Some patients with arrhythmias respond well to short-term medication, while others may need long-term pharmacological treatment or even implantation of a cardiac pacemaker.

For heart failure patients, cardiac function may return to normal in some cases, while others require ongoing medication. Patients experiencing shock or at risk of sudden cardiac death must be treated in a cardiac intensive care unit for close monitoring and advanced life support.