What is myocarditis? What is pericarditis?

Understanding the differences

Myocarditis is an inflammation (‘itis’) of the muscle (‘myo’) of the heart (‘cardium’). Pericarditis is similar, however, the inflammation affects the thin, fluid filled double layered sac that covers and protects the heart, called the pericardium. It is not unusual for both areas to be affected simultaneously, which is called Myopericarditis.

Both myocarditis and pericarditis can cause pain, shortness of breath, altered heart beat and can, if left untreated in some cases, lead to damage of the heart or heart attack. It affects adults and children, and surprisingly can affect people who appear otherwise healthy.

middle aged woman with chest pain holding chest with both hands
melbourne functional medicine practitioner mark payne discussing supplements for functional dyspepsia with patient

How can natural treatments help?

Whilst myocarditis and pericarditis are both rare, they cause significant concern and disruption to health and daily life. Both conditions are much more common in men 12-39 years of age.

Natural, gentle and effective treatments of myocarditis and pericarditis are available, which can be a great relief to people with these conditions. Herbal anti-inflammatory, antiviral and immune modulating medicines, dietary and supplemental nutrients, and lifestyle medicine can all be used to reduce pain and inflammation, and get people with myocarditis and pericarditis back doing the things they love.


Myocarditis and pericarditis symptoms

Symptoms of myocarditis and pericarditis are similar and can be mistaken for heart attack. Pericarditis is one of the most common reasons for heart attack like pain presenting to hospital emergency departments. Therefore, it is always important to seek urgent medical care to rule out heart attack first.

Myocarditis symptoms

Myocarditis symptoms can include:

  • Chest pain, or feeling of pressure
  • Heart palpitations and abnormal rhythms
  • Shortness of breath, especially during exercise, and at night
  • Feeling lightheaded
  • Fluid retention in arms and legs, particularly around ankles and feet
  • Fainting, or sudden loss of consciousness
  • Other symptoms of infection (body aches, joint pain, fever, sore throat)

The pericardium is a fluid filled sac containing the heart that lubricates, protects it from infection, and keeps the heart from over expanding when blood volume increases. Inflammation of the pericardium often develops suddenly and can last several months. There can be extra fluid (called pericardial effusion) due to the inflammation causing back pressure on the heart, making contraction and expansion more difficult.

Pericarditis symptoms

Pericarditis symptoms include:

  • Sharp, stabbing pain which may get worse with coughing, swallowing, lying down or taking deep breaths
  • Pain in the back, neck or left shoulder
  • It can be more comfortable to sit up, lean forward or bend over and hold your chest
  • Anxiety
  • Fatigue
  • Difficulty breathing when lying down
  • Dry cough
  • Swelling in feet, legs and ankles
  • Some people hear a sound of rubbing, or creaking from the chest or lungs, most often when leaning forward or breathing heavily
  • Abnormal heart rhythm

Inflammation of the heart after COVID-19 infection or vaccine

Once thought of as rare, myocarditis is more common in young people aged 12-21, and 90% of cases are in males. More recently, there has been an increase in both cases and awareness of myocarditis and pericarditis due to COVID-19 infection and/or vaccination induced incidents. In Australia, in April 2022 the number of people treated for post vaccination myocarditis was 1399, and these incidents are monitored closely by the Therapeutic Goods Administration (TGA). Less than 20% of COVID-19 vaccination induced myocarditis were admitted to hospital intensive care units in a USA study of 139 adolescents and young adults.

Covid vaccine induced myocarditis or pericarditis can affect any person, of any age or gender. However, internationally the highest risk groups vary by country, vaccine type, gender, age and time between doses. The highest risk groups in Australia are reported as men under 40, between 1-5 days following the second dose of an mRNA vaccine. Moderna presents a higher risk than Pfizer or AstraZeneca vaccines, and the risk profile for Novavax is not yet known (though, a small number of cases were detected in the clinical trial). The risk is much lower in children 5-11 years old, than in adolescents.

Most vaccine related myocarditis cases have been designated as mild, with only brief periods of hospitalisation required for the majority.

Children and adolescents who present to hospital with chest pain or other symptoms of myocarditis or pericarditis, having received Moderna / Pfizer vaccinations within 14 days are treated using a specific algorithm. The Dept. of Health recommends ensuring an 8 week interval between doses one and two of Moderna and Pfizer vaccines for ages 5 -11, and especially for males aged 12-39 years. Subsequent vaccinations of people who have had pericarditis should be assessed depending on inflammatory markers, and have been symptom free for 6 weeks or more. Assessment is made case by case for those with vaccine induced myocarditis.

COVID-19 natural infection induced myocarditis is becoming more common, however case numbers are not accurate as confirmed diagnosis requires an MRI, which is not conducted in all cases. Predominantly, male patients were affected in a review of studies in July 2020, and it is suspected that around 30% of COVID-19 patients experience heart injury. Severity of disease does not determine the likelihood of developing myocarditis.

COVID natural infection induced pericarditis is less common, and more often present as myopericarditis (i.e. alongside myocarditis).

The Dept of Health strongly recommends vaccination of all individuals to reduce the risk of hospitalisation and death from COVID-19. The incidence of vaccine induced pericarditis or myocarditis is very low, however this does not diminish the debilitating effect it has on health and daily life for those affected.

What causes eczema?


Research has found people with the ‘atopic triad’ have a defective barrier of the skin and upper and lower respiratory tracts.

These genetic alterations cause a loss of function of filaggrin (filament aggregating protein), which is a protein in the skin that normally breaks down to create natural moisturisation and protect the skin from penetration by pathogens and allergens.

Filaggrin mutations are found in approximately 30 percent of people with atopic dermatitis, and also predispose people to asthma, allergic rhinitis (hayfever), keratosis pilaris (dry rough patches and bumps on the skin), and ichthyosis vulgaris (a chronic condition which causes thick, dry, scaly skin.)If one parent carries this genetic alteration, there is a 50 percent chance their child will develop atopic symptoms. And that risk increases to 80 percent if both parents are affected. 

Food allergy and sensitivity

Food hypersensitivity has been found to cause or exacerbate atopic dermatitis in 10-30% of cases, and 90% of these are caused by eggs, milk, peanuts, soy and wheat.

Compromised gut health

The connection between the gut microbiome and skin health is complex, however, research has found the microbiota contributes to the development, persistence, and severity of atopic dermatitis through immunologic, metabolic and neuroendocrine pathways.

Nutritional deficiencies

Deficiency of Omega-6 essential fatty acids (EFA) has been linked with the increased incidence of atopic dermatitis, along with the inability for the body to efficiently metabolise EFA’s to gamma linoleic acids (GLA) and arachidonic acids (AA).

Weather and environment

Changing weather conditions can certainly aggravate eczema symptoms, but the triggers are subject to change among individuals.


Hormones also play a role in the course of atopic dermatitis, including the stress hormone cortisol which triggers an inflammatory immune response affecting all organs of the body, including the skin.

Mould exposure

Mould exposure and susceptibility to mould can cause Chronic Inflammatory Response Syndrome (CIRS), of which dermatitis is a manifestation.

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Causes of myocarditis and pericarditis

The majority of cases of myocarditis and pericarditis are reported following viral infection. Symptoms commonly occur around 7-14 days after a viral infection.

Causes of Myocarditis

There are a number of classifications of myocarditis, with the most common being; acute (AM), active, chronic inflammatory cardiomyopathy (infl-CMP), chronic, immune-mediated, immune checkpoint-associated, virus induced, and lymphocytic myocarditis.

Most common triggers for AM and infl-CMP myocarditis are:

  • Viruses - DNA viruses & RNA viruses including the common cold, influenza, respiratory infection, hepatitis B & C, measles, mumps, HIV, herpes simplex, rubella, Epstein Barr Virus (glandular fever / mononucleosis), parvovirus, COVID-19, long COVID and more
  • Bacteria - streptococcus, staphylococcus, brucella, chlamydia and more
  • Protozoa
  • Fungi - (uncommon)
  • Tick-borne pathogens - Borrelia burgdorferi (Lyme disease)

Non-infectious myocarditis triggers include (much less common):

  • Immune mediated - heart transplant rejection
  • Autoimmune diseases
  • Smallpox and tetanus vaccinations
  • Drugs and toxic substances
  • Heavy metals
  • Environmental toxins
  • Scorpion-bee wasp stings and spider or snake bites
  • Allergic reactions
  • Radiation
  • Certain cancers

Causes of Pericarditis

The main types of pericarditis include; acute, chronic, cardiac tamponade (medical emergency), constrictive, infectious, idiopathic (unknown cause), traumatic and uremic pericarditis (due to kidney failure).

Pericarditis causes include:

  • Viruses (most common) particularly affecting the gastrointestinal system
  • Bacterial - tuberculosis is a major cause in developing countries
  • Fungal (rare)
  • Parasites

Non-infectious causes:

  • Some cancers
  • Autoimmune diseases - ankylosing spondylitis, systemic lupus erythematosus, rheumatoid arthritis, Behcet’s disease, myxedema and uremia
  • Trauma, after surgery, accident, or heart attack
  • Diseases such as familial Mediterranean fever
  • Medications - such as immunosuppressants, for cancer or HIV

Whilst the evidence is limited, human studies support the theory that there is an interaction between gut microbiome dysbiosis, the immune system and susceptibility to cardiac inflammation. This is referred to as the heart-gut-immune axis.

Conventional treatment for myocarditis and pericarditis

Conventional treatment for myocarditis and pericarditis starts with investigations to determine the diagnosis, such as:

  • Physical examinations
  • Blood tests to look for inflammation
  • CT scans
  • Cardiac MRI
  • Echocardiogram
  • Chest X rays
  • Electrocardiogram
  • Occasionally, a heart biopsy is required to confirm myocarditis diagnosis

Once diagnosed, medications are usually prescribed for:

  • Pain relief, such as over the counter non-steroidal antiinflammatory drugs (NSAIDs), ibuprofen or aspirin or paracetamol
  • Treating infection - antibiotics, or antifungal medications
  • Reducing recurrent episodes - Colchicine
  • Reducing inflammation - corticosteroids
  • Reducing oedema / fluid retention - diuretics

In extreme cases, surgery may be required to drain fluid from around the heart in people with severe pericarditis. In some people with constrictive pericarditis, a small amount of the pericardium may need to be removed to prevent further constriction around the heart.

If the heart is severely weakened in myocarditis, medical devices such as defibrillators, ventricular assist devices, and extracorporeal membrane oxygenation machines may be required to help restore proper function. If medications and devices aren’t sufficient, then a heart transplant may be required.

Most patients recover fully from both conditions, however, some need to modify their lifestyle due to long lasting symptoms such as avoiding strenuous exercise, reducing salt and fluids, eliminating alcohol consumption and smoking. Some patients require lifelong medications.

Many of the pharmaceutical medications used to treat myocarditis and pericarditis have undesirable side effects, which is why many people seek a more natural treatment for myocarditis and pericarditis.

Functional medicine treatment for myocarditis and pericarditis

Myocarditis and pericarditis functional medicine practitioners treat these conditions with natural, gentle and effective evidence based strategies.

Whether the condition is myocarditis triggered by vaccine, or pericarditis after COVID infection, or any of the other triggers, your functional practitioner will take an in depth look at what the underlying root cause may be of your condition. Paying particular attention to the heart-gut-immune axis, they will investigate where you need additional support to enable the body’s natural healing of pericarditis and myocarditis.

A personalised treatment strategy will be developed that considers your particular set of underlying causes and contributing factors, and other conditions or symptoms you may be experiencing other than pericarditis / myocarditis.

Myocarditis and pericarditis functional medicine treatments may include supporting the immune system to fight off viruses, bacteria, fungi or other pathogens, with herbal medicines such as garlic, andrographis, astragalus and echinacea.

Hawthorn, motherwort, grapeseed, dan shen and corydalis may be used to strengthen heart muscle contraction, increase coronary blood flow, reduce arrhythmias (abnormal rhythms), and protect against heart muscle damage.

Black seed may be used as an antimicrobial and for improving heart function, particularly left ventricular function and blood flow.

In addition to herbal medicines, supplementation to support the immune system, the gut microbiome, and the cardiovascular system may include magnesium, Vitamin C, Liposomal glutathione, CoQ10, precision probiotics and prebiotics, zinc, and Omega 3 fatty acids.

Lifestyle medicine may be employed to reduce the load that stress can play on the cardiovascular system, with stress resilience techniques such as meditation, mindfulness, forest bathing, and vagal nerve stimulation techniques (gargling, singing, yawning), and improving sleep.

Dietary changes to eliminate highly processed, inflammatory foods and to include anti-inflammatory fruits and vegetables, lean grass-fed animal proteins, and fish may also be recommended.

In our 6-month program, your myocarditis / pericarditis functional medicine specialist and your health coach will help you to integrate the treatment plan into your life in a way that is supportive, educating and empowering to give you the best results.

Specialist myocarditis / pericarditis functional medicine practitioner Mark Payne has been a clinical health professional for more than 30 years, in both hospital and natural health environments. He is just one of the team of skilled functional medicine practitioners at Melbourne Functional Medicine who could help you achieve optimal wellness again.

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Can you naturally recover from myocarditis?

Yes, most people do recover naturally from myocarditis however, some do have long lasting symptoms.

To give yourself the best chance of a full recovery, you need to ensure that your body has all it needs to support healing.

A healthy and robust immune system is something that you can work on, by looking after your body, eating well, staying hydrated, sleeping well, and ensuring you build stress resilience into your daily life.

Seeking the help of a natural health myocarditis and pericarditis functional medicine practitioner who can identify your root causes and contributing factors is a good way to start your healing.

Can you reverse myocarditis?

It depends on how long you have had the myocarditis and if there is any damage to the muscle of the heart.

If you seek natural treatment for myocarditis as soon as possible after diagnosis or symptoms arise, then you have the best chance of healing as quickly and efficiently as you can.

Even if it is not possible to reverse the damage, there are a variety of ways you can still improve your cardiovascular function and overall health to ensure your heart functions optimally and prevent recurrence

What herbs help myocarditis?

There are many wonderful herbal medicines that may address different aspects of your health to help myocarditis / pericarditis - depending on what the root cause and contributing factors are of your condition. Some of these include the following:

Garlic, andrographis, astragalus, curcumin (turmeric) for supporting the immune system to fight off viruses, bacteria, fungi or other pathogens, with the following herbal medicines.

Hawthorn, motherwort, grapeseed, dan shen and corydalis to strengthen heart muscle contraction, increase coronary blood flow, reduce arrhythmias (abnormal rhythms), as antioxidants, and protect against heart muscle damage:

Black seed as an antimicrobial and for improving heart function, particularly left ventricular function and blood flow.

Seeking the help of a myocarditis and pericarditis functional medicine specialist is the best way to learn which herbs are suitable for you. Herbs are natural, but they can still interact with medications, and may not be appropriate for you. Just like pharmaceutical drugs they are best prescribed by a professional who can tailor the right treatment for you and ensure you are safe.

What is the best medicine for myocarditis?

The best medicine is always the one that provides support for the body to heal, while not causing it harm.

Natural herbal treatments for myocarditis are gentle, and effective by supporting heart function, immune system function, and the gut microbiome - all integral to healing myocarditis.

How do you calm down pericarditis? What makes pericarditis worse?

Pericarditis is inflammation (‘itis’) of the pericardium - the fluid filled sac that protects the heart. Inflammation is a natural response of the immune system trying to protect the body against a perceived threat, however, when it does not resolve it causes problems.

Anything that causes the body to be more inflamed will cause pericarditis to be worse, and anything that is anti-inflammatory will calm down pericarditis.

Pharmaceutical anti-inflammatories suppress the body’s immune response, but do not address the root cause and can have side effects when used for more than 14 days.

Seeking pericarditis natural treatments as an alternative is what many people prefer, as the herbal anti-inflammatories used do not suppress inflammation - instead they support the immune system to resolve inflammation. These might include turmeric (curcumin), garlic, black seed (nigella), andrographis and astragalus. These herbs are often used in conjunction with other herbal medicines like hawthorn, dan shen, and motherwort for supporting heart muscle and pumping function.

A myocarditis and pericarditis functional medicine specialist can identify why your body isn’t resolving inflammation and properly prescribe the right herbs for your condition, to ensure the best recovery from pericarditis.

Can turmeric help with pericarditis? Can fish oil help in pericarditis?

Yes, both fish oil and turmeric are powerful anti-inflammatory medicines for pericarditis natural treatment.

Turmeric and oily fish are both great food sources of the constituents curcumin and omega 3 fatty acids respectively, however it is difficult to get sufficient dosages for a highly inflammatory condition such as pericarditis through food alone.

High quality supplements are necessary, as buying cheap supplements for cucumin (turmeric) and Omega 3’s (fish oil) can do more harm than good as they can be adulterated, oxidised, or of poor quality.

In both cases, it is best to see someone who can prescribe high quality products, such as a pericarditis natural treatment specialist.

What foods help pericarditis?

Anti-inflammatory foods will help to reduce the inflammation in the body and provide it with the nutrients needed for healing. Eat as many of the following as you can:

  • Whole, unprocessed, fruits and vegetables, preferably with the skins on
  • Lean, ideally grass fed animal proteins and fats
  • Healthy cold-pressed fats such as avocado, extra virgin olive oil
  • Wild caught sardines, mackerel, anchovies, salmon and herring
  • Eat organic, whenever you can
  • And, drink 2 litres of filtered water every day

Make sure to eliminate fast foods, highly refined carbohydrates, sugar, and sweetened / carbonated drinks, alcohol, and smoking / vaping.

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