Therapy of Acute myocarditis I:
Physical activity is avoided in the acute phase.
Because of the high incidence of LV dysfunction, standard therapy for heart failure is administered. Beta-blocker treatment should be avoided in the acute phase of decompensated heart failure and in the very early treatment of fulminant myocarditis.
In patients with suspected myocarditis, however, the lack of beta-blocker treatment is associated with poor outcome.
Digitalis is contraindicated, whereas dihydropyridines may be beneficial but not in acute heart failure.
In animal studies, NSAIDs have increased inflammation and mortality and should be given at the lowest required dose in patients with perimyocarditis in whom LV function is clearly normal and who have prominent chest pain from pericarditis.