Basic facts about myocarditis

DEFINITION

Myocarditis is an inflammation of heart muscle that is characterized by diffuse or focal infiltration in the interstitium and perivascular, which leads to the degeneration of miofibriles.

CAUSE

First Unknown etiology

Second Nonspecific (bacteria, viruses - coxackie, parasites, allergies, toxic, metabolic)

Third Specific (rheumatism, tuberculosis, syphilis, collagenosis)

The most common cause of viral myocarditis is Coxackie B virus. The virus damages the myocardium in 3 ways: invasion, toxin, autoimune mechanism.

CLINICAL PRESENTATION

1) = Asymptomatic patients with focal myocarditis

2) = Symptomatic patients may have systemic disease, with mild signs of heart disease

3) Cardiac syndrome-chest pain due to myocarditis or signs of heart failure

4) arrhythmias and sudden death

Symptoms depend on the preservation and the ability of myocardial contractility. All agents acting equally on the right and the left myocardium

A rapid reduction in cardiac output leads to dyspnoea and even ortopnoic, the change effort. There is a malaise, lassitude, dizziness, syncope, cold extremities, cyanosis is present.

If inflammation of the pericardium and procedures, there is intense pain similar to angina in the mediastinum, only it lasts longer and does not stop at nitroglycerin, but the metamizol.

When infectious myocarditis, there is a booster temperatrue, Short-term

Auscultation is registered: tachycardia, and muffled heart sounds on top,

X-ray: enlarged, triangular heart

Kardiofrenični-angles are obtuse

-Path in the hilus

ECG: ST-elevation light, with negative T (lesion-ischemia)

-In severe damage miofibrile present a picture of myocardial

-Atrial and ventricular ektrasistole

-AV and bundle branch block

LABORATORY DIAGNOSIS: bacteriological, virological and serological analysis

Complications

-Global heart failure

-Thrombosis in the cavities of the heart, embolism

-Sudden death, especially during physical activity

DIG. DG: acute pericarditis. According to the course may be acute, subacute and chronic.

THERAPY

-Treat the cause of the disease

-Constant control

-Strict bed rest

-Symptomatic therapy of arrhythmias and heart failure

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