Myocarditis: A Growing Heart Risk

By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.

For at least the last couple of decades, I’ve discussed the dangers of chronic inflammation and its link to countless health conditions, including heart disease, cancer, and diabetes.

In fact, for the majority of my heart disease patients, their problems were the result of years of uncontrolled chronic inflammation wreaking havoc on their bodies.

On more rare occasions though, I had patients with heart inflammation that developed as a result of other conditions. These unique situations were a total reversal of the norm.

Heart inflammation—a blanket term for three inflammatory conditions: pericarditis, myocarditis, and endocarditis—has always been a relatively uncommon event. But recently, it has thrust its way into the spotlight due to its link to COVID-19.

Since it’s a timely topic, and there’s a lot of conflicting information out there, I thought it would be a good idea to give an integrative cardiologist’s perspective on heart inflammation and what can be done about it.

Types, Causes & Symptoms of Heart Inflammation (Carditis)

There are three types of heart inflammation:

  • Myocarditis: inflammation of the heart muscle
  • Pericarditis: inflammation of the outer lining of the heart
  • Endocarditis: inflammation of the inner lining of the heart valves (which can spread to intraventricular lining adjacent to the valves).

In general, inflammation is the body’s way of responding to an infection or some other trigger. It is no different with heart inflammation. Some type of foreign body (virus, bacterium, etc.) or infection prompts the heart or heart lining to become inflamed.

Bacterial infections, most often Staphylococcus aureus, are the leading cause of endocarditis.

According to The NIH National Heart, Lung and Blood Institute, viral infections—including adenovirus, herpes, coxsackievirus, influenza, and SARS-CoV-2 (the COVID-19 virus)—are the top cause of both pericarditis and myocarditis.

I used to treat patients who experienced myocarditis after getting the flu. As a cardiologist, I worry about how viral infections like this affect the heart. Blood circulation through the heart and lungs is very interconnected, sharing the same blood vessels. With COVID-19, I suspect we will see more and more cases of heart inflammation surface in the months and years ahead.

In my practice, I had also seen cases of myocarditis attributed to Lyme disease—a bacterial disease carried by ticks. And in some cases, fungal infections (Candida or Aspergillus) can lead to myocarditis and pericarditis; but usually, other underlying conditions such as HIV are also present.

Additional potential triggers include:

  • Autoimmune diseases, such as rheumatoid arthritis and lupus
  • Use of certain medications, including antidepressants, antibiotics, diuretics, benzodiazepines (tranquilizers), and weight loss and psychiatric meds. Even some heart meds like amiodarone and procainamide (anti-arrhythmics), and hydralazine and methyldopa (both used to treat blood pressure) are linked to heart inflammation.
  • Environmental toxins like heavy metals and radiation
  • Vaccines, which can initiate an allergic reaction in some people that ends in heart inflammation.1-2

Most recently, myocarditis has been recognized, in various studies as well as by the FDA, as a known side effect of the COVID-19 mRNA vaccines. Those at highest risk of this side effect are young men ages 16–29, after receiving the second dose of the vaccine.3-5 

According to updated Facts Sheets provided to vaccine administrators by Moderna and Pfizer for all ages (including 5-11 years):

Although some cases required intensive care support, available data from short-term follow-up suggest that most individuals have had resolution of symptoms with conservative management. Information is not yet available about potential long-term [conditions].”6-7

Heart inflammation is serious because it can affect the heart’s ability to pump, setting off arrhythmia (changes in heart rhythm). As the condition becomes more severe, the heart can’t deliver blood to the whole body. Clots can also form, increasing risk of heart attack, stroke, and sudden death.

How to Keep Blood Healthy & Reduce Risk of Blood Clots

Symptoms of heart inflammation include:

  • Chest pain, which may feel like sharp jabs when taking deep breaths
  • Heart palpitations
  • Fainting
  • Shortness of breath
  • Profound fatigue; inability to exercise
  • Swelling due to fluid retention
  • Loss of appetite
  • Fever
  • Weakness

There are no routine screening tools for heart inflammation, so you need to be your own advocate. If you experience any of the symptoms above, especially in combination, seek emergency help right away.

Conventional Treatment for Carditis

For mild cases of heart inflammation, doctors usually recommend monitoring. The inflammation oftentimes resolves on its own.

For more severe cases, surgery and/or various drugs are the usual course of action. Depending on the type of inflammation and the underlying infection, this may include antibiotics, antifungals, anti-inflammatories, corticosteroids, blood thinners, and/or various heart medications.

Once recovered, follow-up care is critical. Your doctor may recommend routine blood tests to check for inflammation, cardiac MRIs, and echocardiograms to make sure the heart remains stable.


Unfortunately, repeat events can happen. In fact, after your first occurrence of heart inflammation, you’re at higher risk of another episode for several years—which is why it is so important to take steps to prevent this from happening.

For one, continue taking whatever medications you’re given until your doctor gives you the OK to stop. Also do not exercise until you get your doctor’s blessing to start working out again.

Very importantly, stick to an anti-inflammatory diet. Avoid alcohol, which can lead to decreased heart function and heart failure, and caffeine, which can instigate arrhythmias.

Take steps to minimize stress, which negatively impacts your heart and overall health. One way to do this is to breathe slowly and deeply as often as you can. Grounding is another way to help minimize the effects of stress. In fact, one study I personally worked on showed that grounding can have a balancing effect on the nervous system, and as a result, positively impact heart function.

Through another small study I was involved in, two straight hours of grounding was shown to lower blood viscosity (that is, thin the blood) and improve blood flow. While this effect on its own cannot be said to prevent myocarditis and other forms of heart inflammation, having blood that is less prone to clotting is an advantage.

When possible, avoid other known causes and risk factors:

  • Infections: I know it’s hard to fully avoid catching a bug without living in a sterile bubble. But do your best to keep your immune system strong so that your body can do its best to stave off the flu, COVID, or whatever else may come its way.
  • Medications: Make sure whatever drugs you’re taking don’t have heart inflammation as a possible side effect. This includes vaccines. If you developed myocarditis after getting a vaccination, you probably should avoid getting future shots of that vaccine. Discuss your concerns, as well as a risk-benefit analysis, with your doctor.
  • Radiation: I’m a firm believer that exposure to radio frequency (RF) and electromagnetic field (EMFs) can have serious adverse health effects. Research shows links to diseases of the heart and brain, cancer, immune system dysfunction, and more. Take steps to limit your exposure.
  • Autoimmune diseases: If you have an autoimmune disease, work with your doctor to manage it so that you reduce the risk of flare-ups.

Finally, shore up your heart health with supplements known to protect your ticker: CoQ10, omega-3 fatty acids, zinc, and pyrroloquinoline quinone (PQQ). All of these support the cells’ mitochondria (energy factories) and help prevent heart cells from getting inflamed.

Some preliminary findings suggest that PQQ—a compound made by bacteria and found in fruits and vegetables—may have the ability to reduce heart inflammation post-COVID infection/vaccination, though more thorough research needs to be conducted.8

Heart inflammation, though rare overall, has indeed become more prevalent in the last year. This is not something that should be swept under the rug, as I fear cases will only continue to increase as COVID-19 continues to impact our communities.

I don’t want to alarm you—Lord knows everyone has had enough to be concerned about these past few years. But I do urge you to become familiar with the symptoms and be aware when something doesn’t feel right. Trusting your gut and being proactive with your health can help prevent serious consequences.


  1. National Heart, Lung, and Blood Institute. Heart Inflammation and Heart Inflammation: Causes and Risk Factors, last accessed March 27, 2022.
  2. Cleveland Clinic. Myocarditis, last accessed March 27, 2022.
  3. Witberg G, et al. Myocarditis after Covid-19 Vaccination in a Large Health Care Organization. N Engl J Med. 2021 Dec 2,385(23):2131-9.
  4. Gundry S. Abstract 10712: Observational Findings of PULS Cardiac Test Findings for Inflammatory Markers in Patients Receiving mRNA Vaccines. 2021 Nov;144:A10712.
  5. FDA Press Release. Coronavirus (COVID-19) Update: June 25, 2021. Last accessed March 27, 2022.
  6. Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) Emergency Use Authorization of the Moderna Covid-19 Vaccine to Prevent Coronavirus Disease 2019 (Covid-19). Revised January 31, 2022; last accessed at gov on March 27, 2022.
  7. Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) Emergency Use Authorization of the Pfizer-BioNTech Covid-19 Vaccine to Prevent Coronavirus Disease 2019 (Covid-19). Revised January 31, 2022; last accessed at gov on March 27, 2022.
  8. Boretti A. PQQ Supplementation and SARS-CoV-2 Spike Protein-Induced Heart Inflammation. Nat Prod Comm. 2022 Mar;17(3):1-4.

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