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  • Myocarditis: symptoms and treatment, signs, causes

    Myocarditis is an inflammatory process in the heart muscle, which worsens such functions as conduction, excitability and contractility.

    Among all cardiac diseases, the incidence of myocarditis is 5-10%.Since many mild forms of the disease occur with a blurred clinical picture, it is not so easy to diagnose a disease.

    The disease occurs from the influence of various infections, in autoimmune diseases and allergies, with the influence of chemical and physical factors.

    Based on the degree of pathology, a certain form of damage to the heart cells appears:

    1. 1) Acute. She is characterized by heart failure and borderline myocarditis. After the disease, the tissue structure is partially restored.
    2. 2) Chronic active. Develops cardiomyopathy. Foci of inflammation often persist after recovery, in the tissue visible huge cells and fibrosis.
    3. 3) Short-term. Cardiogenic shock, severe pathologies of the left ventricle develops. There are multiple foci of acute inflammation, sometimes cardiomyocytes are destroyed. Complete recovery comes when the help is provided in time.
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    4. 4) Chronic persistent. No manifestations of pathology at the initial stages, normal functions of the left ventricle are preserved.
    Subsequently, active border myocarditis appears, and heart failure also develops. Basically for today the main part of pathologies - myocarditis is perfectly cured, with no consequences for the body does not appear. To prevent the formation of further consequences, it is extremely important to begin adequate and timely treatment.

    Causes of myocarditis


    How does the disease develop and what is it? Myocarditis can occur for various reasons. First of all, these are viral and bacterial infections. Because of measles, flu, rubella, diphtheria, scarlet fever, sepsis, pneumonia and other diseases, this pathology may occur. In addition, myocarditis can appear due to the Coxsackie virus, viral sore throat, hepatitis, adenovirus, typhoid, typhus, and other infections.

    Is it known that the incidence rate increases during epidemics?and also that myocarditis can arise because of two or more different infections. Provoke the appearance of the disease can be alcohol poisoning, as well as poisoning with chemicals. In addition, the disease can occur because of problems with the immune system. This is possible even with the administration of medications and the administration of sera without the appointment of a doctor.

    The origin of some types of myocarditis( idiopathic) is still unknown. Because exercise can only exacerbate the problem, patients can not engage in active exercise.

    Symptoms of myocarditis


    After a week from the onset of the disease, the following symptoms appear, which, however, are not specific:

    • increased heart rate or bradycardia.
    • fast fatigue.
    • excessive sweating.
    • pain in the chest.
    • fever.
    • shortness of breath.
    • joint pain.
    • asthenization.
    • pallor of the skin
    At the initial stage, asthenic syndromes are manifested: irritability, sleep problems, rapid mood changes, excessive tearfulness. After that, there is pain of varying degrees in the region of the heart, which does not bind to excessive loads. Also there are interruptions in the work of the heart muscle, there is an increased palpitation.

    A disease that occurs without loss of left ventricular function usually has no clear symptomatology. Patients with signs of impaired functioning of the left ventricle often suffer from fatigue, dyspnea, uncomfortable sensation in the heart.

    Diagnosis of myocarditis


    Usually myocarditis is diagnosed as a "suspicion of inflammation of the heart muscle".The disease can be diagnosed by ECG, with an increase in heart volume, and also found heart failure.

    In ECG examination, the appearance of 3 and 4 tones, muffled, systolic murmur. It is also possible to raise the RS-T, the appearance of a negative asymmetric T wave with a reduced amplitude. With such an examination as Echocardiogram, the disease can be determined only in the most neglected cases. With radiography, it is possible to detect an increased volume of the heart, as well as some pulmonary stagnation.

    Often, the doctor also prescribes a blood test showing an increase in ESR, C-reactive protein, etc. In some cases, an imunogram is prescribed, in which there is a rise in the CEC, antibody titer, and a decrease in the number of T-lymphocytes.

    The most effective analysis can be called intracardiac biopsy. Although it is permissible only when it comes to the complex course of the disease. And still, it's difficult to know exactly whether the diagnosis is "myocarditis".The doctor can recommend a patient, to measure the temperature daily to determine the diagnosis. Since most of the symptoms are nonspecific, contact the doctor.

    Treatment of myocarditis


    In the acute stage of the disease, the patient is recommended to be hospitalized with full restriction of physical exercises, as well as observance of bed rest for 1-2 months until complete recovery.

    Diet in myocarditis is a reduced amount of salt and liquid, enriching the food with protein and vitamins to harmonize the metabolic process in the myocardium.

    Treatment includes various therapies:

    1. 1) Decreased infection rate. When bacterial infections are effective antibiotics, and for viral - antiviral drugs.
    2. 2) Sanitation of pathological infectious foci. After tonsillitis, prostatitis, sinusitis, or any other disease that provokes the disease is detected, a microbiological test is performed to recover and no infection.
    3. 3) Non-steroidal anti-inflammatory drugs( aspirin, ibuprofen), immunosuppressive and antihistamines( claritin).In severe cases, the course of the disease may be prescribed glucocorticoid hormones( prednisolone).
    4. 4) Riboxin, papangitis, asparkam, ATP, as well as vitamin complexes are used to increase the metabolism in the heart muscle. If the patient does not have a contraindication to a large amount of potassium, it is prescribed in sufficiently large doses.
    Patients with myocarditis also prescribed prophylaxis of thromboembolic complications, anticoagulants, as well as antiplatelet agents, are prescribed for this purpose.

    The duration of myocarditis treatment is about 6 months, and sometimes more. The course of therapy depends on the effectiveness of prescribed drugs and on following the patient's basic treatment rules. The patient is under compulsory medical supervision for the first months after the illness.

    Forecast


    With uncomplicated myocarditis, there is complete recovery without consequences. In complex cases, everything depends on the degree of myocardial inflammation.

    In the case of subsequent heart failure, half of patients notice improvements after therapy, 25% have cardiac function stabilization, others have complications. With myocarditis with heart failure, the predictions can be based on the degree of lesion of the left ventricle.

    Bad predictions for giant cell, myocarditis after Chagas disease and diphtheria myocarditis. These patients often resolve questions about heart transplantation.

    Possible complications of


    The chronic course of myocarditis generates:

    • sclerotic lesions of the heart muscle;
    • myocarditis cardiosclerosis;
    • arrhythmia;
    • heart failure.

    Prevention of myocarditis


    To prevent disease, prevention is necessary. It first includes compliance with precautionary measures when dealing with patients.

    In epidemics, it is recommended to avoid visiting places of congestion of a large number of people, and also use Oxoline ointment, vitamin C, echinacea and other means to strengthen immunity and prevent disease. It is also necessary to identify and timely sanitize inflammatory foci in the body. Mandatory preventive vaccinations against rubella, scarlet fever, mumps, measles, influenza, poliomyelitis are mandatory.

    After the patient has completed therapy, it is necessary to observe the cardiologist every 2-3 months.


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