Heart disease, such as viral myocarditis, needs to be considered when you have chest pain but not coughing when you have a cold. Viral myocarditis is common in young patients and often has symptoms of viral infection such as fever, malaise, generalized lethargy, or gastrointestinal symptoms such as nausea and vomiting in the early stages of the disease, after which palpitations, chest pain, dyspnea, and edema occur. Physical examination may reveal tachycardia that does not parallel the degree of fever, as well as various types of arrhythmias, third heart sounds or murmurs, and also signs of heart failure such as jugular venous anger, pulmonary rales, hepatomegaly, and edema. On the electrocardiogram, it often shows ST-T changes and various types of arrhythmias, with ventricular arrhythmias and atrioventricular block predominating. Echocardiography may show hypo-diastolic left ventricular function, segmental or diffuse ventricular wall motion. Elevated troponin and cardiac creatine kinase, increased hematocrit, and increased high-sensitivity C-reactive protein may aid in the diagnosis.