myocarditis is heart inflammation or to be more specific it's inflammation of the heart muscle
pericarditis is inflammation of the pericardium or the outer lining of the heart myocarditis and
pericarditis often occur together hence the term myopericarditis how often is it caused by covid
how often is it caused by the mrna vaccines pfizer and moderna and what are the symptoms
of heart inflammation how is it diagnosed i'm going to unpack all this in this video and if
you're new here i'm dr mike hansen welcome to my channel where i love to break down medical topics
and provide you with real medical explanations this is my dog legend he likes balls
myocarditis is an interesting diagnosis because it can present in a variety of ways
not just in terms of various signs and symptoms but a variety of non-specific
labs in the blood work non-specific ekg findings non-specific echocardiogram findings meaning
ultrasound of the heart also most people with this diagnosis have zero or mild symptoms
now on the flip side it can rarely present with sudden cardiac arrest
and even if you are able to make the diagnosis it's usually even trickier to determine the cause
there are lots of different things that can cause myocarditis heck even heavy metal can cause it
you might also notice there that smallpox vaccine can cause it well i should say could cause it
because routine vaccination of the american public against smallpox stopped in 1972 after the disease
was eradicated but the most common cause of myocarditis is a result of the immune system
reacting to a viral infection common viral triggers include adenovirus coxsackievirus
influenza parbovirus b19 and herpes and of course you can add covid to that list as well as
the pfizer and moderna vaccines but before we get into the details of cases of myocarditis
after the vaccine let's get a baseline understanding of the seriousness of myocarditis
disease severity can range from unnoticeable to mild symptoms to severe illness requiring icu to
death more often than not it's a mild temporary issue in more serious cases when there's more
heart inflammation the heart has a harder time pumping blood which can lead to heart failure
the highest risk population for myocarditis is from puberty to the age of the 30s
so it affects males more often than females there are no specific symptoms that are associated with
myocarditis but the common symptoms include chest pain or chest pressure shortness of breath fatigue
swelling in the hands and feet heart palpitations lightheadedness and a
sudden loss of consciousness in the early stages of viral myocarditis patients will
usually initially have fever in muscle aches now if there's pericarditis to go along with
that myocarditis the most common symptom is going to be chest pain and that's usually a sharp or
stabbing pain but some have a dull achy or pressure-like chest pain a diagnostic
clue with pericarditis is that the chest pain is worse when lying flat and better when sitting up
making the diagnosis of myocarditis depends on signs and symptoms lab tests including
troponin levels and bnp certain ekg findings and echocardiogram findings usually a chest x-ray will
be normal but can sometimes show an enlarged heart coronary angiography meaning a heart cath or heart
catheterization is sometimes necessary to rule out coronary artery disease as a potential diagnosis
cardiac mri is indicated in patients with suspected myocarditis with elevated troponin
levels or if they have ventricular dysfunction especially if they don't have a clear cause such
as ischemic heart disease meaning coronary artery disease some might ultimately require a biopsy of
their heart called an endomyocardial biopsy but that's usually reserved for those who are very ill
even though covid is a respiratory virus it can affect the heart in several ways
first when covid causes pneumonia it can damage the lungs decreasing the amount of
oxygen that gets to the heart and making it harder for it to pump blood to the body
this is known as demand ischemia second the inflammatory response from the immune system
to fight that virus is sometimes excessive the cytokine storm that you hear about it's a cascade
of cytokines and chemokines of the immune system and that can ultimately damage organs in the body
basically it's collateral damage so the damage from this inflammatory response
is known to especially affect the kidneys brain and the heart and that's when you have myocarditis
and as if that's not bad enough inflammation can cause small blood clots or micro thrombi
to form in different blood vessels throughout the body including in the capillaries of the heart
more than four thousand children have suffered from multi-system inflammatory syndrome in
children so mis-c which can cause inflammation of the heart the lungs the kidneys and the brain as
well as other organs finally sars cov2 can also infect the heart muscle cells themselves a study
from washington university school of medicine in st louis it showed that the sars cov2 virus
invades the heart muscle cells and interferes with contraction researchers there used stem
cells to model the contracting heart muscle tissue their research showed that the viral infection it
actually destroys the muscle cells and you're left with a heart that doesn't pump blood on a related
note when we talk about covid long haulers one of the common symptoms that i see from patients
in my pulmonary clinic is that they have this chronic central chest pain or chest pressure
especially when taking in a deep breath my suspicion is that there might be a small
degree of persistent myopericarditis going on there but that's hard to know one way or another
as of june 10th about 4 million children have contracted covid this number represents 14 of
all cases and is about 5 300 cases per 100 000 children about 17 000 children have
been hospitalized and 330 have died covid has been in the top 10 causes of pediatric death
since the pandemic began now as a comparison 188 children died of influenza in the 2019-2020 season
the cdc has also reported that as of june 9 2600 plus people under the age of 30 have died of covid
there have been cases in very small studies looking at patients who developed myocarditis
after getting the covid vaccine the cdc has received 1200 plus preliminary reports
of myocarditis and pericarditis following about 300 million total doses of the pfizer and modern
vaccines these preliminary reports came through the vaccine adverse event reporting system that's
maintained by the cdc in the fda among people 12 and older there were 267 reports of heart
inflammation after one dose of the vaccine 827 after the second dose and then 132 after
an unknown dose the cdc continues to recommend covid 19 vaccination for everyone 12 years of
age and older why that's because for every million second dose vaccinations with either the moderna
or the pfizer there have been tens of myocarditis cases but thousands of covid 19 cases that are
prevented for males aged 12 to 17 it's estimated that for every 1 million second dose vaccinations
there are 5 700 covid cases 215 hospitalizations 71 icu admissions and 2 deaths that are prevented
with an estimated 56 to 69 myocarditis cases for females in that same group age 12 to 17
it's estimated that for every 1 million doses to complete a two dose series of that vaccine
you get 8 500 covid cases 183 hospitalizations icu admissions and one death that would be prevented
compared to 8 to 10 cases of myocarditis and then when you look at the bracket of age 18 to 24 those
numbers look even better since wednesday there's been a joint statement from the leaders of more
than a dozen health agencies and organizations including the cdc the american academy of
pediatrics the american heart association and more and they're all saying that the covid vaccines
are safe ineffective and that they strongly encourage everyone 12 and older to be vaccinated
against covid 19 this is their conclusion quote the conclusion is that myocarditis is an extremely
rare side effect and only an exceedingly small number of people will experience it
after vaccination importantly for the young people who do most cases are mild and individuals recover
often on their own or with minimal treatment in addition we know that myocarditis and pericarditis
are much more common if you get covid 19 and the risks to the heart from covid 19 infection
can be more severe we recommend getting vaccinated right away if you haven't yet it's the best way to
protect yourself your loved ones your community and to return to a more normal lifestyle safely
and quickly that's all for this video thank you for watching and if you liked it give it a like
and if you haven't done so already don't forget to subscribe and hit that bell notification see you