The day after it became known that Reiter would not return to the town hall and would immediately hand over the official duties to Krause. As the “tz” reports, according to voices from the town hall, the disease is probably an inflammation of the heart muscle, which can be fatal if left untreated. “I ignored the warning signs,” said Reiter. Now he has to take it easy and rest in the long term.

What is inflammation of the heart muscle (myocarditis)?

The heart muscle pumps blood through the body from our central organ. If it is inflamed, it can have serious consequences – but it doesn’t have to be. Because not all myocarditis are the same. This is what inflammation of the heart muscle is called in technical jargon.

What can trigger myocarditis

The cause of inflammation of the heart muscle are mostly viruses, for example Sars-CoV-2flu and cold pathogens or the Epstein-Barr virus. Bacteria and fungi are also on the list of culprits.

Myocarditis can also be caused by medications such as immune checkpoint inhibitors in cancer treatment, toxic substances or a rheumatological disease.

If you see six warning signs, you should see a doctor

Inflammation of the heart muscle is often difficult to recognize. The German Heart Foundation explains: The complaints are often non-specific. They were often reminiscent of a respiratory or gastrointestinal infection that may have just been overcome.

The heart experts recommend seeing a doctor at the latest if

1. tiredness and fatigue last longer than usual after an infection

2. or are particularly strong.

In this way, it can be clarified whether myocarditis may also exist. These four signs can also indicate inflammation of the heart muscle:

6. Cardiac arrhythmias (heart palpitations)

Even then you should get checked.

On the trail of myocarditis

Unlike a heart attack, for example, the diagnosis of myocarditis is much less clear. Rather, the heart experts are looking for clues.

Myocarditis can be reliably detected by taking tissue from the heart, a so-called biopsy, more precisely an endomyocardial biopsy. A cardiac catheter can also rule out a circulatory disorder in the coronary arteries or other heart diseases. This is advanced via the artery at the wrist or in the groin to the heart and forms the coronary arteries. However, both procedures involve risks, so they are usually only used in special cases.

Doctors usually work with the following methods, like Volker Schächinger, clinic director of Medical Clinic 1 at the Fulda Clinic, from the Heart Foundation executes:

• ECG: The electrocardiogram (ECG) can be used to determine whether the heartbeat is triggered normally but is too fast (sinus tachycardia).
• Ultrasound examinations of the heart (echocardiography): Cardiologists use ultrasound to assess the pumping performance of the heart. This can be limited in the case of myocarditis. In myocarditis, the heart chambers often pump significantly less blood into the body than in healthy people.
• Blood values: Here too, more than one value is needed for the diagnosis puzzle. One of the so-called biomarkers for heart damage is troponin-T. Troponin-T provides evidence of myocarditis, especially in children, in whom a heart attack can almost be ruled out.
• Cardio MRI: Cardiac magnetic resonance imaging detects swelling, tissue destruction or scarring locally in the heart muscle.

Therapy: This is how myocarditis is treated

Inflammation of the heart muscle can rarely be treated specifically. In any case, this is not necessary for every myocarditis. First of all, those affected should always take it easy. This means that they should avoid physical exertion and stay in bed in acute cases.

The heart needs rest so that the inflammation can heal. Sport is taboo for six months, says Michael Böhm on the website of the German Heart Foundation. He is press spokesman for the German Society for Cardiology. In the case of asymptomatic myocarditis, no further therapies are routinely required.

“In severe forms, doctors primarily rely on medication to stabilize the heart’s pumping function, reduce inflammation and avoid long-term damage,” writes Böhm.

Cardiologists treat symptomatic myocarditis similar to heart failure (heart failure). They give medication to relieve the pressure on the heart and stabilize the pump. These can be, for example, calcium antagonists or beta blockers, ACE inhibitors, sartans and diuretics.

In addition, those treating the virus fight the viral infection that causes it. Patients receive high doses of immunoglobulins for a short time as an infusion. These proteins act as non-specific antibodies and switch off viruses.

Myocarditis overcome – and then what?

It is difficult to say how long myocarditis lasts. If you want to do intensive exercise again afterwards, you should get checked out beforehand. Myocarditis usually heals and the heart is fully functional again. In some cases, however, scars remain that inhibit strength and pumping ability.

Anyone who has survived myocarditis should minimize long-term risks. A heart-healthy life includes, for example, avoiding obesity, smoking and an unbalanced diet. Depending on how severe the myocarditis is, those affected should have a follow-up examination every three to six months. This means that heart failure can be identified as quickly as possible and treated if necessary.