Myocarditis- focal or diffuse inflammation of the myocardium; is manifested by a violation of its contractility, excitability and conductivity. There is no generally accepted classification of M. According to the classification, the cut is based on etiological, pathogenetic, clinical and morphological signs, distinguish the trail. forms of myocarditis in children: bacterial, viral, infectious-allergic, non-infectious-allergic - medicinal, idiopathic, or M. Abramova — Feed-leur, serum. The causes of M. may be infectious, infectious-toxic or toxic. The toxic-allergic nature of myocardial damage has also been recognized. By the duration of the disease M. subdivided into acute and chronic, the prevalence - focal and diffuse.
CLINICALLY, the severity of the condition is determined by the rapid development of cardiac and sometimes vascular insufficiency. Deterioration of the general condition is noted, weakness and increased fatigue, complaints of pain in the heart area (aggravated by physical.load), dyspnea (associated even with a slight physical stress), pale skin. In severe cases, there are observed the cyanosis of the lips and nails with fiz. load, cardiac arrhythmias (tachycardia, extrasystole, atrial fibrillation). The sizes of the heart determined by percussion are directly dependent on the severity of the course of M. Heart sounds are usually muffled.
DIAGNOSIS M. is based on the anamnesis, clinic. symptoms, laboratory results (determination of leukocytosis, monocytosis and eosinophilia, increased ESR) and instrumental studies (echocardiography, phonocardiography, cardiac sounding), as well as indirect research methods
TREATMENT: cardiac drugs, drugs that improve metabolic processes in the heart muscle; antibiotics and chi-myopreparations - with infectious diseases. M. When allergic M. leading is hyposensitizing therapy.
PREVENTION M. should be directed to the prevention and treatment of diseases in which M. develops (primarily viral and bacterial infections). In the presence of foci of chronic. infection is required rehabilitation.
Chronic non-cardiac myocarditis (electrocardiogram of a patient of 5 years).Significant violations of the shape and height of the P wave, deformation of the QRS complex, ST interval offset below the isoline, reduction and inversion of the T wave.
Myocarditis- This is an inflammatory lesion of the heart muscle.
- infectious (viral, bacterial, rickettsial, etc.);
- allergic (drug, serum, vaccine-free);
- with diffuse connective tissue diseases, injuries, burns, exposure to ionizing radiation;
- idiopathic (that is, unexplained nature) Abramov-Fiedler myocarditis.
The leading role in the development of the inflammatory process belongs to allergies and impaired immunity.
Myocarditis begins with infection or soon after it with malaise, sometimes stubborn pains in the heart, palpitations and interruptions in its work and shortness of breath, and sometimes soreness in the joints. Body temperature is normal or slightly elevated. The onset of the disease may be invisible or hidden. Early increase the size of the heart. Important, but not permanent signs are violations of the heart rhythm (tachycardia - its rapidity, bradycardia - its reduction, atrial fibrillation, extrasystole) and conduction (various blockades).
Acoustic symptoms may occur - deafness of tones, gallop rhythm, systolic murmur. Myocarditis may be complicated by the development of heart failure, the appearance of blood clots in the cavities of the heart, which, in turn, carried by the blood flow, cause the death (infarction) of other organs (thromboembolism). The course of the disease can be acute, subacute, chronic (recurrent).
Bed rest Early administration of glucocorticoid hormones (prednisone), nonsteroidal anti-inflammatory drugs (aspirin, butadione, ibuprofen, indomethacin). Treatment of heart failure, heart rhythm disturbances and conduction is under way. Apply agents that improve metabolic processes in the heart muscle: retabolil, nerabol, riboxin, vitamins B and C. With a protracted course of the disease - delagil, plaquenil.
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