The main pathogens that cause fulminant myocarditis are viruses, such as enteroviruses (especially coxsackievirus group B), adenoviruses, influenza viruses, and EBVs.
This is because viruses can cause direct damage to the myocardium. Viruses can also work in conjunction with the immune response to damage the myocardium. In addition, there are a variety of cytokines and NO-mediated myocardial damage and microvascular injury. All of these changes can impair myocardial tissue structure and function.
Outbreaks of myocarditis begin with fever, malaise, runny nose, sore throat, cough, and diarrhea. This may be followed by symptoms such as shortness of breath, dyspnea, chest tightness or chest pain, extreme malaise, and a marked decrease in appetite, which may be aggravated or even fainting when performing physical labor. Some patients may rapidly develop acute left heart failure or cardiogenic shock, with pulmonary circulation stasis or shock manifestations.
Sudden onset and rapid progression of fulminant myocarditis, early mortality is high, must be diagnosed and treated early. Treatment includes antiviral therapy with paramivir combined with acyclovir or ganciclovir, and immunomodulatory therapy with high-dose glucocorticoids and gammaglobulin. The rest include close monitoring and maintenance of circulatory stability.
Therefore, if you suspect that you have fulminant myocarditis, you need to seek medical treatment promptly to avoid delay.