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Hormone treatment may be ineffective in treating people with viral myocarditis

Viral infection occasionally triggers myocarditis (inflammation and necrosis of the heart muscle) which can result in serious, acute heart failure. The first signs of this condition may be flu‐like symptoms which evolve into non‐specific chest discomfort, shortness of breath or palpitations. The majority of patients recover spontaneously but others have continuing heart problems which require medication and can be severe enough to cause death.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Intravenous immunoglobulin for presumed viral myocarditis in children and adults

Acute myocarditis is inflammation of the heart and is thought to be most commonly begin as a viral infection. The disease affects individuals of all ages. On the basis of multiple case reports and case series, intravenous immunoglobulin (IVIG) has become part of routine practice for treating adults and children with acute myocarditis at many centres. This is an update of a previous review, which found only one randomised trial of 62 adults, suggesting that IVIG is not useful in myocarditis. A second trial was added with this update. This trial evaluated 83 children who had the relatively rare combination of myocarditis and encephalitis (inflammation of the brain). Investigators found a lower death rate among children receiving IVIG than in those who did not, but this study had high risk of bias. More study is required before IVIG can be routinely recommended for adults or children with myocarditis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Herbal medicines for viral myocarditis

Viral myocarditis is a disease where the muscles in the walls of the heart become infected with a virus. Herbal medicines are used as treatment for diseases such as viral myocarditis. Many clinical trials have been conducted to investigate how effective herbal medicines are for viral myocarditis, and this review aimed to find out whether they work.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Anti‐inflammatory treatment in the form of corticosteroids and immunotherapy to prevent heart damage resulting from rheumatic fever

This is an update of a review published in 2003 and previously updated in 2009 and 2012. For this latest update, the search was rerun on 17 October 2013, and no new studies were found. Rheumatic fever is a late complication of a type of throat infection caused by streptococcal bacteria. It is an immune system disease that can lead to inflammatory disease of the heart (carditis), joints, brain and skin. Carditis can cause heart failure and death. Various anti‐inflammatory drugs have been used to treat carditis, including corticosteroids, aspirin and immunoglobulins (immune therapy using antibodies). No new trials were identified in this update. This review includes eight trials with 996 participants. Evidence shows little effect of corticosteroids over aspirin in preventing cardiac disease after one year (six studies, 907 participants, risk ratio 0.87, 95% confidence interval 0.66 to 1.15). Several steroidal agents such as corticotrophin, cortisone, hydrocortisone and dexamethasone were compared with aspirin before 1966, and prednisone and immunoglobulins were compared with placebo in studies from 1990 and 2001, respectively. Most studies did not report on adverse events, but those that did reported complications due to corticosteroids including weight gain, enlarged facial features and acne. Trials were generally old (six of the eight trials were conducted between 1955 and 1965), small and of poor quality and had high risk of bias. For this reason, results should be interpreted with caution.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Digitalis for treatment of heart failure in patients in sinus rhythm

Digitalis is a drug that is extracted from the leaves of the foxglove plant. It contains substances that stimulate heart muscle. The drug has been used for over two centuries to treat heart failure—a condition caused by inability of the injured heart to pump blood adequately. Other drugs that may be useful include diuretics, angiotensin‐converting enzyme inhibitors, and beta‐blockers, but digitalis may also be beneficial. The review of trials found that digitalis reduces hospitalization and can help to relieve symptoms of heart failure. More research is needed to show the full effects of digitalis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

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