Treatment of myocarditis

  How to treat myocarditis needs to be judged according to the cause, clinically, viral myocarditis is more common. In addition to antiviral treatment, rest, symptomatic and supportive treatment is generally the main focus.  The name “viral myocarditis” does not exist in Chinese medicine, but from the point of view of its pathogenesis and clinical manifestations, it is equivalent to the category of “heart disease” and other diseases in Chinese medicine. The “heart”, also known as the heart heat disease, refers to the external sensation or due to surgery and other trauma, the evil of warmth and toxicity to take advantage of the invasion of the heart, the heart’s muscle, endothelium, to fever, palpitations as the main manifestation of the internal organs (heat) disease type of disease.  The treatment of myocarditis in Chinese medicine can be divided into acute and chronic treatment, and should be treated according to the evidence. In the acute stage, if wind-heat offends the lung and heat disturbs the heart and mind, it is necessary to remove the wind and detoxify the heat, clear the ligament and calm the heart. The formula is Yin Qiao San plus or minus. If the problem is evil poisoning of the heart and deficiency of both qi and yin, the formula should be used to clear heat and detoxify the heart, benefit qi and nourish yin. In case of Yang deficiency and Qi detachment, we should return Yang to rescue the rebellion and benefit Qi to fix the detachment. The formula is Ginseng and Longmu Tang with addition and subtraction. The chronic phase should also be treated according to different symptoms.  The supportive therapy for myocarditis is mainly related to the clinical manifestations of the patient. In patients with asymptomatic or mild symptoms, myocarditis can recover in about 1 week. Patients should reduce physical activity and rest, while symptomatic treatment can be given for upper respiratory tract infection symptoms such as fever, fatigue, muscle aches, or gastrointestinal symptoms such as nausea, vomiting, and diarrhea. Patients with cardiac symptoms often require hospitalization and symptomatic treatment according to the type of clinical symptoms, mainly including anti-arrhythmic and heart failure correction: some patients with arrhythmias can recover with short-term medication, while others may require long-term medication or pacemaker implantation; some patients with heart failure can recover to normal heart function, while others require long-term medication. Patients with shock or even sudden death need to be treated in the cardiac intensive care unit.