Viral Infection

In April 2010, fans of the Colorado Rockies were shocked when Keli McGregor, the president of the Rockies since 2001, was found dead in his hotel room in Salt Lake City. McGregor was a seemingly healthy, 48-year-old former athlete who lived an active life and kept himself in good shape, regularly lifting weights, hunting, and golfing.

A few months later, the family issued a statement saying that McGregor’s death was caused by a viral infection of the heart. The virus attacked the heart muscle, causing inflammation and disrupting the electrical pathways that signal the heart to beat properly, leading to heart failure. McGregor was completely unaware, experiencing only flu-like symptoms before he passed away.

Viruses can affect the heart, just like any other type of body. Viral infection, in turn, can cause inflammation—a condition called “myocarditis.” Most of the time, the body will heal itself and you may never know you had a problem. However, in rare cases such as McGregor’s, the infection itself and the resulting inflammation can damage and weaken the heart, which can lead to heart failure and/or heart rhythm irregularities.

Types of Viruses that May Cause Viral Heart Infection

Though a wide variety of viruses may affect the heart, there are a few that are more commonly linked to myocarditis and other heart problems.

Adenovirus

This virus most commonly causes respiratory infections and may sometimes cause bladder and bowel infections. It can also infect the heart. It’s one of the most common viral causes of myocarditis in both children and adults. The virus spreads through contact with droplets from the nose and throat of an infected person.

Cytomegalovirus (CMV)

This group of viruses includes the herpes simplex viruses, varicella-zoster virus (which causes chickenpox and shingles), and the Epstein-Barr virus (which causes mononucleosis). According to the Centers for Disease Control and Prevention (CDC), about 50 to 80 out of every 100 people are infected with CMV by the time they’re 40 years old.

 Typically, CMV lays dormant and harmless in the body, but it can cause infections, including viral heart infection. This virus has also been associated with a 24 percent higher risk of stroke or cardiovascular death and was also found in one study to be the most common viral culprit in fatal myocarditis. The viruses are spread through contact with body fluids of an infected person, or from a pregnant woman to a fetus during pregnancy.

Coxsackievirus B

This is the most common cause of viral heart infection or myocarditis, blamed for about half the cases in the United States. Although it also can cause the flu, it may attack the heart, creating an infection that lasts about two to 10 days, with cardiac symptoms potentially arising within two weeks. Symptoms may include fever, fatigue, and chest pains. It doesn’t usually cause death, but may result in permanent heart damage, particularly if it recurs a second time. This is a fecal-orally transmitted virus, which may be avoided by improving sanitation and thoroughly washing hands.

ECHO (Enteric Cytopathic Human Orphan) Viruses

This family of viruses typically cause gastrointestinal infections and skin rashes and is common in the United States, mostly in the summer and fall. The virus can also cause viral heart infection and myocarditis. You may contract the virus by coming into contact with contaminated stools, or by breathing in air particles from an infected person.

Epstein-Barr Virus

This virus is part of the CMV group of viruses. It causes mononucleosis and is one of the most common human viruses. According to the CDC, as many as 95 percent of adults between 35 and 40 years of age have been infected. This virus is also considered a common cause of myocarditis. Transmission of the virus requires intimate contact with the saliva of an infected person.

Human Parvovirus B19

This virus causes the so-called “fifth disease,” a mild rash illness that is more common in children than adults. It’s also occasionally associated with acute myocarditis. The virus spreads through saliva or nasal mucus, when a person coughs or sneezes. Washing hands and covering your mouth and nose when you cough or sneeze can help reduce the spread of the virus.

Rubella

Known as the virus that causes German measles, rubella can also cause viral heart infection. It’s also associated with miscarriages, stillbirths, and birth defects, and if it infects the heart, can cause myocarditis, although it’s not one of the more common viruses to do so. Fortunately, there is a vaccine available for this virus.

Symptoms and Treatment

Because many viral heart infections create no visible symptoms, the infection oftentimes goes unnoticed. Symptoms that may occur, however, include an abnormal heartbeat, chest pain, fatigue, fever, muscle aches, sore throat, joint pain or swelling, leg swelling, fainting, or shortness of breath. However, blood tests, electrical testing, X-rays, and nuclear heart scan testing can show signs of stress on the heart and may alert a doctor to the issue.

Treatment for viral heart infection may include medications like antibiotics (to treat the infection), anti-inflammatory medicines to reduce swelling in the heart, diuretics to remove excess water and edema, a low-salt diet, and reduced activity. If the heart muscle has been damaged or weakened, the doctor will treat the resulting issues, such as administering medications to even out abnormal heart rhythms or help reduce the risk of blood clots. Overall, treatment will vary depending on the severity of the infection and the resulting effects on the heart.