Is It Myocarditis or Just Autonomic Nervous System Dysfunction?

I'm not sure if it's myocarditis or just autonomic nervous system dysfunction?

Hello doctor, I have been experiencing a cold for almost two weeks.
Two weeks ago, I had severe coughing and a runny nose, but I am feeling much better now.
However, in the last couple of days, I have started to experience chest tightness and palpitations, with occasional dull pain in my heart area (like a pressure sensation).
It comes and goes; for instance, I might feel the tightness in the morning but not in the afternoon.
I do not have shortness of breath, and my temperature has been around 36.5 to 37.1 degrees Celsius.
I am worried about the possibility of myocarditis and would like to know how likely it is to develop myocarditis after a cold.
I was previously diagnosed with autonomic nervous system dysfunction, which improved, so I stopped taking medication for a while.
Today, I went for a follow-up appointment to get my medication.
I am unsure if I need to go to the hospital for further examination or if I am just overthinking it.

Junxiang, 10~19 year old female. Ask Date: 2023/02/06

Dr. He Dongjin reply Cardiology

Hello, the likelihood of developing myocarditis from a cold is low.
It's common to experience chest tightness and palpitations during a cold, so try not to overthink it and scare yourself.
Changhua Hospital cares about your well-being.

Reply Date: 2023/02/06

More Info

It sounds like you're experiencing a range of concerning symptoms, including chest discomfort, palpitations, and a history of autonomic nervous system dysfunction. Given your recent upper respiratory infection, it's understandable to be worried about the possibility of myocarditis, especially since viral infections can sometimes lead to inflammation of the heart muscle.

Myocarditis is an inflammation of the heart muscle that can be caused by viral infections, among other factors. Symptoms can include chest pain, fatigue, shortness of breath, and palpitations. However, it's important to note that not everyone who has a viral infection will develop myocarditis. The incidence of myocarditis following a viral infection is relatively low, but it can occur, particularly with certain viruses like the flu or COVID-19.

Your symptoms of chest tightness and palpitations could also be related to your history of autonomic nervous system dysfunction. This condition can lead to a variety of symptoms, including anxiety, which can manifest as physical symptoms like chest discomfort and heart palpitations. The fact that your symptoms fluctuate throughout the day (e.g., chest pain in the morning but not in the afternoon) may suggest that they are more related to anxiety or stress rather than a structural heart issue.

Given your history of autonomic nervous system dysfunction and the recent respiratory illness, it would be prudent to consult with your healthcare provider. They may recommend further evaluation, such as an electrocardiogram (ECG) or echocardiogram, to assess your heart's function and rule out myocarditis or other cardiac issues. Additionally, they may consider checking inflammatory markers or cardiac enzymes if myocarditis is suspected.

It's also worth mentioning that if you experience any worsening symptoms, such as increased chest pain, shortness of breath, or fainting, you should seek immediate medical attention. These could be signs of a more serious condition that requires prompt evaluation.

In summary, while the risk of developing myocarditis after a viral infection exists, your symptoms could also be attributed to your previous autonomic nervous system dysfunction. A thorough evaluation by a healthcare professional will help clarify the situation and determine the appropriate course of action. It's always better to err on the side of caution when it comes to heart health, so don't hesitate to reach out to your doctor for further assessment.

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