Causes, symptoms, diagnosis, prognosis.
Myocarditis is called inflammatory disease of the heart muscle, which is accompanied by a violation of its function. The prevalence of myocarditis is unknown, as is often the disease occurs without significant clinical manifestations and ends complete recovery. The disease can develop at any age, but it is believed that the disease is predominantly young. The average age of patients is 30-40 years. Women are slightly more likely to suffer from men, but men are more likely to have severe forms of myocarditis.
Causes of myocarditis.
The causes of myocarditis are very diverse. More than half of the cases are due to infection, and such myocardium is called infectious. Call disease can virtually any infectious agent, but the most common pathogens are viruses (influenza viruses and Coxsackie type B, cytomegalovirus, rubella virus, measles, chicken pox, herpes, hepatitis B and C, human immunodeficiency virus, etc.). Bacterial myocarditis is less common, but it is more severe. The most common is diphtheria myocarditis, which complicates the course of diphtheria in 10-25% of cases. You should specifically say about myocarditis caused by β-hemolytic streptococcus group A, it is a manifestation of rheumatic heart disease is different from myokardytov has a different nature and require special treatment and prevention. The doctor, diagnosing myocarditis, often means the nonreumatic nature of the disease.
Myocarditis may accompany some systemic connective tissue diseases, such as red lupus, scleroderma, rheumatoid arthritis.
Allergic myocarditis occurs during medication (for some antibiotics, non-steroidal anti-inflammatory drugs, for the administration of serums and vaccines), as well as as a result of the bite of insects.
Myocarditis develops under the influence of physical factors: with burns, irradiation; May occur in rejection of the graft of the heart.
In some cases, the cause of myocarditis remains unrecognized.
Manifestations of myocarditis.
The most commonly occurring viral myocarditis, and therefore, most patients have indications for a transient (1-2 weeks before heart complaints) infectious disease (fever, runny nose, sneezing, feeling "scurvy" in the body, pain in the m Joints and joints, general weakness, sometimes stomach upset and abdominal pain).
The disease clinic depends on the prevalence and localization of the process, so even a small inflammation center in the leading heart system can lead to severe heart rhythm disorders.
If the malosymptomatic course of complaints from the heart may not be at all. Weakness, fatigue, a slight increase in temperature are regarded as residual effects after an influenza.
In other cases, patients note pain in the heart, dull, aching, often long and monotonous, usually without spread (irradiation) in other areas of the chest. The pains are not related to physical activity and do not pass after taking nitroglycerin. Heartburn and interruptions in the work of the heart (due to the development of various disorders of the rhythm) may appear in peace and intensify during physical activity. As a result of the development of severe heart rhythm disorders, myocarditis may be the cause of sudden death.
In the widespread inflammatory process, the expansion of the cavities of the heart occurs, and the manifestations of heart failure (dyspnea, edema on the legs, pain in the right hypochondrium) appear to be at the forefront in the clinical picture.
The diagnosis of myocarditis important role played instrumental examination of the patient (laboratory data, electro- and echocardiography, chest radiography, scintigraphy mokarda). According to modern concepts, the final and reliable diagnosis of myocarditis can only be established by the results of cardiac biopsy, but in real clinical conditions, an indication of this study can serve only as a severe form of disease, resistant to drug therapy, when the issue of heart transplantation is resolved.