General information about the disease
From the heart of all the pathologies of myocarditis4-11%. However, the light forms of the disease, occurring with no clearly and accurately marked clinical picture, which is hard to measure, are much more common. For the first time research and study of inflammation of the heart muscles began to engage in the first quarter of the nineteenth century. Myocarditis may develop under the influence of a number of infections (culprits include viruses, bacteria, fungi, protozoa), physical, chemical, and allergic factors (burns, Injuries, exposure to ionizing radiation), andheart transplantation and autoimmune diseases. Depending on how damaged heart cells, whether attenuated their ability to perform their functions, pathology leakage occurs in the following forms:
- Galloping - for it is characteristic of cardiogenicshock, dysfunctional lesions of the left ventricle, many foci of inflammation, destruction of myocardial cells. But if assistance is provided in a timely manner, it is possible to hope for a full recovery, with damaged areas restored tissue.
- Acute - manifested heart failure that develops as a result of boundary myocarditis, fabric forms after only partially restored.
- Chronic active - it combines allsigns mentioned earlier, there is a development of cardiomyopathy, inflammatory lesions persist even after recovery, laboratory studies show fibrosis and giant cell sizes.
- Chronic persistent - initial manifestationsno disease, left ventricle functions normally, gradually developing border myocarditis (active), leading to the development of heart failure that persists after the inflammatory reaction will take place.
The overwhelming majority of cases identifiedmyocarditis in our time successfully cured without harmful effects to the human body due to the existing arsenal of high-tech medical diagnostic methods. Severe forms are fatal, is extremely rare. It is important to recognize the pathology, promptly appoint a treatment to a patient, so as not to give a chance to develop other related ailments.
The symptoms of myocarditis
If the doctor suspects an inflammation of the heart muscle, thefor an accurate diagnosis it is necessary to have data on the dynamics of an electrocardiogram (ECG). When myocarditis increased size of the heart, reveals sharp and keep progressing congestive heart failure, swollen neck veins.
During the examination of the heart may occur:
- systolic murmur at the apex of the heart muscle that is not associated with the first tone when changing body position, its intensity does not change;
- congestion in the lungs.
your doctor may prescribe to confirm the diagnosis:
- Chest x-ray (which indicates whether the increased size of the heart, if there is a partial signs of pulmonary congestion).
- Blood test in the laboratory (general, immunologic and biochemistry).
- Intracardiac (endomyocardial) biopsy (shown with heavy pathology within).
- Echocardiogram (it allows to reveal pathological changes in the myocardium).
- Magnetic resonance imaging and pozitronnoemissionnuyu (to visualize the area of violations and myocardial necrosis).
In moderate to severe myocarditis patientshospitalized without fail. Ambulatory treated only mild forms of the disease. Patients need to be rational (high-grade) nutrition, food should be prepared with the addition of restriction in their salt. Should abstain from alcoholic beverages, cigarettes. Physical activity for a period necessary to significantly reduce the disease. In the first weeks of the disease relies comply with bed rest.
Now MirSovetov list the basic principles of drug treatment of myocarditis:
- All forces are directed at the source of the inflammation. In establishing its perpetrators are appointed antibacterial, antiviral or antiparasitic drugs.
- The non-specific anti-inflammatory therapy involves the use of Ibuprofen, Indomethacin, Voltaren, Xefocam, meloxicam glucocorticosteroids (with an immunosuppressive effect, such as prednisolone).
- To suppress allergies shown antihistamines.
- To improve the metabolic (exchange) processes in the myocardium designate Panangin, Asparkam, potassium orotate, kokarboksilazu, Riboxinum ATP.
- Oxygen Inhalation.
- At the same time symptomatic treatment emergent complications or comorbidities.
The most common types of myocarditis:
- Infection - arises due to the introduction inmyocardium infectious agents (viruses, fungi and bacteria). This myocarditis most often develops in the airway inflammation, influenza, measles, rubella, mumps, diphtheria, scarlet fever, HIV infection. When infectious agents begin to destroy the cells of the myocardium, the fight take immune antibodies. There is a disruption and destruction of infected cells, there is destruction of the myocardium. Gradually, these areas are replaced by connective tissue, which leads to cardio, followed by compensatory myocardial hypertrophy. If inflammation of the myocardium caused by bacteria that are formed pockets of abscesses containing bacterial pathogens. In this myocarditis in the first week of treatment should not be prescribed NSAIDs and glucocorticoids.
- Allergic myocarditis - one of the manifestationsallergic reaction, infection occurred, whey products, drugs, toxins ... This pathology usually develops in the hearts of the departments to the right or in the interventricular septum. If not carried out the necessary treatment, it is fraught with diffuse cardiosclerosis occurring with degenerative lesions of the muscle fibers. In the future, everything is going to rheumatic heart disease.
- Idiopathic myocarditis Abramov-Fiedler -the nature of this disease is not clear, then combined with myocarditis, heart failure, conduction disorders and rhythm, the formation of clots (thrombi). The flow of this type of acute myocarditis, may end in death. First, the tissue breaks down in the middle of inflammation, then there is a scarring, leading to an apparent cardio.
The duration of the treatment and recovery periodIt is determined by various factors, including the severity of the disease, the general state of health and the effectiveness of complex therapy. When secretive (latency) during the inflammation of the heart muscle is entirely possible spontaneous recovery forces of the organism. In more severe cases always need help doctors to avoid complications. After suffering a myocarditis need some time seen by a cardiologist.