Myocarditis is an inflammation of the heart muscle, which is usually caused by viruses, although it can be caused by any of the other microorganisms (bacteria, fungi, rickettsia, protozoa). For people who are suffering from myocarditis main symptom is the appearance of unusual fatigue and disproportional. Fatigue occurs in unusual speed increasing degree. Patients complain that they can not walk long, often have to rest, breathe rapidly and have shortness of breath. Often pause while climbing the stairs and take breaks when climbing, but the first or second floor. These symptoms occur because of more or less weakening of the heart muscle.
In severe cases there are rhythm disorders, with a sense of irregular heartbeat. When the membranes are affected by heart (the pericardium - pericardium) may feel chest pain. Echocardiography can accurately determine the degree of wall motion of the heart muscle. In myocarditis, the mobility of the heart muscle is reduced in certain parts (segments), which does not depend on the propagation through the arterial muscle. In this way we can distinguish myocarditis from coronary heart disease, in which there is a reduction of contractility in areas where blood supply is reduced due to narrowing of heart arteries. These changes in myocarditis are usually discrete. In severe forms can be found a significant decrease in strength of heart muscle.The reduction of mobility can be diffused, so that the whole heart becomes less mobile, a heart muscle weak and flabby.
There are a number of other characters that we can indicate the presence of myocarditis, but a sufficient reason for the emergence of a strong review of cardiac fatigue and shortness of breath. Laboratoryanalyzes can indicate the presence of inflammation (increased sedimentation rate, elevated white blood cell count, changes in differential blood count, elevated C-reactive protein, etc.).. Analysis of specific antibody titers (which should be elevated at least four times) can determine the type of virus that is affecting the myocardium. However, the only sure diagnosis of myocarditis is cardiac muscle biopsy, with histologic analysis of tissue samples obtained by cardiac muscle. A biopsy is done only in severe cases of myocarditis.
Coxsackie is the first among dangerous viruses
The most common causes of myocarditis include:
Coxsackie (COXSACKIAE VIRUS) - At least twenty different types of viruses can cause myocarditis. However, the most common is Coxsackie virus, which is responsible for more than 50 percent of cases of viral myocarditis. Named after the town in the USA where it was first isolated 1948th year. It is often forgotten that it belongs to a group of entero viruses, which cause intestinal infections, so that the disease first manifests upset stomach, usually as diarrhea and abdominal cramps. Also, this virus can give transient redness of the throat with a blistering and lesions of the skin (usually the palms and soles). Very often leads to inflammation of the lining of the heart with the occurrence of effusion fluid around the heart. The virus multiplies more intense in young children. In older dominant pain in the upper lung tissue, muscle aches, symptoms of upper respiratory tract inflammation and joint pain. In severe cases, may appear and chest pain, feeling of heart skipping a fever and the fever, while in serious cases there is severe attenuation of cardiac function and pulmonary edema (stagnation of blood in the lungs). Cardiac enzymes may be normal or elevated. Echocardiographic findings are diffuse or regional wall motion disorders of the left ventricle, which usually improves over time. Most patients recover completely within a few weeks, although electrocardiographic changes can be found for months after infection. Rarely ends fatally. In some patients later disease becomes chronic and may be experiencing symptoms of the development of dilated cardiomyopathy.
CITOMEGALOVRIS is very often unrecognized infections in young children. Most adults have antibodies to this virus, which means that they once had this infection. Infection after 35 years is rare. Severe infections usually occur in imunosupressed patients with malignant diseases. Unfortunately, when pregnant is a possible infection of the fetus with heart defects and anomalies of development.
Hepatitis rare heart surgery. In some forms can lead to severe myocarditis.
INFECTIOUS MONONONUKLEZA disease is usually easy, which is common in the teenage age. It is spread by respiratory and other infections. Leads to enlargement of the lymph glands neck, sore throat and can lead to enlargement of the spleen. In rare cases, inflammation of the heart develops in the membrane (pericarditis), accompanied by pain, which may simulate myocardial infarction.
IS THERE A "HEART GRIP"
Influenza (flu) - Although it is rare clinically recognizable myocarditis, pre-existing heart disease significantly increases the risk. During influenza epidemics, about 10 percent of infected people may have cardiac symptoms.Heart problems usually occur for a week or two after onset and can be serious because of the lack of air, a sense of irregular heartbeat, chest pain, arrhythmia and heart failure. Usually there is involvement of the heart lining (pericardium). On the electrocardiogram can find a variety of changes: cardiac bradycardia, tachycardia, various forms of cardiac impulse disorders implementation.
Lyme disease (Lyme carditis) - is caused by a spirochete that is transmitted by the tick. It usually begins with a characteristic rash (Raša) in the skin, and then the next weeks and months, heart, joint and neurological symptoms (sometimes years). About 10 percent of heart disease surgery. The most common manifestations are cardiac arrhythmias-occurrence of slow implementation and iregular heart pulse - heart blocks).Unconsciousness and even complete loss of consciousness as a result of arrhythmias, are common. Lyme disease is successfully treated with antibiotics.
Rubella is a contagious viral infection that is classically manifested by fever, conjunctivitis, enlarged lymph glands in the neck and behind the ear shells. The rash appears first on the skin of the face and spreads to the trunk and limbs and usually only lasts three days. People are infectious before and one week after the rash appears (RAS). It is usually a mild disease, but can be very dangerous for pregnant women and unborn child.Rubella virus can cause serious fetal damage, hearing loss, brain malformations, blindness, mental retardation and heart defects. In severe cases, measles can cause inflammation of the heart muscle. The vaccine is safe and effective. Mumps virus (mumps) and measles, can also cause myocarditis.
Trichinellosis (Trichinella spiralis) - The first symptoms may appear for 12 hours after eating contaminated meat (usually pork jerky). The inflammation causes nausea, vomiting, sweating and diarrhea. Five to seven days after the first symptoms can come to the island and comes face and fever. From the tenth day of intense symptoms include muscle pain, difficulty breathing, loss rate and lowering blood pressure and damages the heart muscle and nerve complications. Death may occur due to weakening of the heart, kidney or lung function.
It can be concluded that myocarditis in most cases a mild disease, and occurs spontaneously recovered completely. Preventive measures against some forms of myocarditis are possible - the only sanitary eating meat tested (trichinosis), vaccinations (influenza, measles, mumps), and protection from tick bites during their stay in the countryside. Against viruses that are transmitted through respiratory (droplet infection) is difficult to implement effective prevention. Treatment of myocarditis is often only symptomatic (alleviating pain, reducing fever) as well as the usual respiratory infections. In severe forms of heart failure are given different combinations of medication (cardiotonic, AC inhibitors, diuretics, antiarrhythmics, corticosteroids, immunosuppressants). Restriction of physical activity in the active phase, is one of the most important measures that can influence the course of the disease.
FREQUENTLY STILL WITHOUT CONSEQUENCES
Myocarditis is usually a mild disease that does not leave any impact on human health or affect cardiac function.A person with myocarditis often causes no symptoms (asymptomatic myocarditis), or seek medical attention. In two percent of people who are killed in car accidents histological slices of the heart muscle, the unexpected is myocarditis, this disease is usually not treated, nor sought medical attention. It will develop a form of myocarditis, depends on the genetic predisposition. The same virus in different individuals can give a completely different clinical picture.
CAUTION
For each suspected myocarditis, rapid appearance of fatigue, irregular heartbeat and chest pain, a condition that is similar to the flu, do cardiological examination and laboratory blood tests.
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