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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Basic facts about atherosclerosis

Definition

Atherosclerosis is the most common and most serious illness in a group of diseases called arteriosclerosis-disease that is characterized by arterial wall becomes thinned and less elastic. In atherosclerosis is specifically caused by the creation of plaques (atheroma) in the inner layers of the arterial wall, which can reduce or obstruct (disable) the flow of blood. The incidence of atherosclerosis is increased in postmenopausal women and thus approaches the incidence in men the same age. Vascular diseases that affect the brain, heart, kidneys and other vital organs and limbs is the leading cause of morbidity and mortality in the U.S. and most Western countries. Mortality due to coronary heart disease (heart blood vessel disease) among men, whites, between the ages of 55th and 64 amounts to 1/100.

It is assumed that atherosclerosis is caused by increased levels of fatty substances lipoprotein-LDL in the blood with one hand and damage to the endothelium (inner layer of the arterial wall-the first blood flow) caused by different mechanisms on the other. The most important risk factor for atherosclerosis are age, male sex and premature atherosclerosis in the family anamnesis.

Other risk factors include: elevated levels of low density lipoprotein (LDL) and reduced levels of high density lipoprotein (HDL), hypertension, smoking, diabetes, obesity, physical inactivity, increased levels of homocysteine ​​can cause endothelial damage, and infection with the bacteria Chlamydia pneumoniae, which can also have a role in the formation of endothelial damage.

The clinical picture

Atherosclerosis is usually not diagnosed until a critical stenosis (narrowing), thrombosis (blockage of blood vessels clot occurred otrgnućem atheroma), aneurysm (cleavage of arterial wall) or embolism (clot in the lungs stop). Symptoms of the disease usually develop gradually as the atheroma grows and closes the lumen of blood vessels. It is first apparent inability of additional blood supply to certain organs in the consequent, which is manifested in the contraction of heart muscle exertion (angina pectoris), painful pulsations in the extremities (intermittent claudication).

If there is a sudden blockage of major arteries and symptoms are much more dramatic example. ischemic cerebrovascular accident (stroke came clogged blood vessels in the brain clot occurred because of atheroma rupture )

Diagnostic evaluation

Atherosclerosis is diagnosed based on the symptoms and signs, it should be a suspect and if they present some risk factors. Obstruction of atheroma may be confirmed by angiography (examination of blood flow in vessels with contrast) or by Doppler echocardiography (ultrasound examination types where the difference in the flow of blood through a blood vessel, due to atheroma, defined in different colors on screen display)

Treatment

Treatment of atherosclerosis is actually focused on the treatment of its complications: myocardial infarction, angina pectoris, arrhythmias, stroke and so on. So here is extremely important to prevention which includes measures to reduce risk factors that may favor the development of atherosclerosis. So important is proper nutrition without excessive introduction of fats and sugars, exercise, regulation of body weight and blood pressure, not smoking.

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