Heart failure after viral infection

Dear Dr. Roach: My sonin-law had Guillain-Barre as a child, and is now 39 and a new father. He has an executive job with nothing strenuous. He cannot get the flu shot and consequently got the flu. He has been diagnosed with an infection around the heart.

Recently he was told he may never return to work and cannot do any heavy lifting or exercising. My concern is about what is going to happen to his quality of life. Why are the doctors telling a 39-year-old man that sitting on the sofa for the rest of his life is the outcome? Is there truth to this? — A.R.

My suspicion is that your son-in-law has suffered a serious complication of a viral infection: viral myocarditis. It is a rare complication of several viral infections. The virus and the body’s response to it both can damage the heart muscle. I suspect your son-in-law has developed heart failure due to an infection.

With heart failure, the heart is unable to pump the blood the body needs and maintain low pressures to keep the lungs healthy. Heart failure causes fatigue and low energy, as well as shortness of breath. Symptoms can range in severity.

Since this apparently was only diagnosed in a short period of time, it’s important to note that the prognosis is highly variable. Most people will recover a great deal. But it is possible that his course may be much longer.

Even severe cases may be successfully treated. There are many effective medications, and things like aids to heart function and transplant can be considered. That kind of severe heart failure should be managed by an expert.

The diagnosis of viral myocarditis is difficult to make with certainty. The most definitive test is a biopsy.

While there is an excellent chance for full recovery, those with myocarditis have about a 50% mortality at five years.

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