Abramov-Fidlera's myocarditis

Description:

Abramov-Fidlera's myocarditis differs in heavier, sometimes in a malignant current with development of a cardiomegaly (owing to sharply expressed heart dilatation), heavy disturbances of a rhythm and conductivity, heart failure.
Pristenochny blood clots in cardial cavities with thromboembolisms on big and small circles of blood circulation are quite often formed.
The epidemiology - a disease most often strikes rather young healthy people of middle age.
Average age of patients makes 42 years. A ratio of men and women among patients approximately equal.
At 19% of patients autoimmune diseases, for example Hashimoto's thyroiditis, Takayasu's arteritis, a disease Krone were noted.

Reasons of myocarditis of Abramov-Fidlera:

The etiology of myocarditis of Abramov-Fidlera is not known. There are 3 ideas of an etiology of this disease:
Abramov-Fidlera's (acute isolated myocarditis) myocarditis is just option of a heavy course of myocarditis of a different etiology with the autoallergichesky mechanism of development. Often an initiator of process is medicamentous influence.
Abramov's myocarditis - Fidlera (acute isolated myocarditis) - the viral infection starting autoimmune mechanisms.
Attentive viewing of drugs of Abramov and Fidler, and also protocols of autopsies of patients allowed some researchers to express opinion that Abramov described a dilyatatsionny cardiomyopathy, and Fidler - heavy diffusion myocarditis.

Symptoms of myocarditis of Abramov-Fidlera:

In most cases Abramov-Fidlera's myocarditis has the acute progressing, quite often malignant current with development of right ventricular or total heart failure.
Symptoms of right ventricular or total heart failure, as a rule, prevail in usually mixed picture of clinical manifestations though the onset of the illness in certain cases can correspond to thromboembolic or arhythmic options.
The chronic current of an acute isolated myocarditis more often happens recurrent to progressing of fibrosis of a myocardium after each recurrence. Cases of the hidden current of the acute isolated myocarditis which is coming to the end with sudden death are described.
It is necessary to suspect existence of an acute isolated myocarditis when:
Complaints to an asthma at a small exercise stress prevail, the expressed fatigue, interruptions in cardiac performance.
Very much early the heart sizes with bystry (within several days) formation of the cardiomegaly found perkutorno and radiological increase.
Very often at acute isolated myocardites the thromboembolic syndrome is observed.
The megaliya is observed gepato-and spleno.

Treatment of myocarditis of Abramov-Fidlera:

Conditions of performing treatment: all patients with suspicion of Abramov-Fidlera's myocarditis are subject to hospitalization.

Non-drug methods of treatment:
Bed rest.
Smoking cessation.
Dietotherapy.  The Diet No. 10  with restriction of table salt is recommended, at diffusion myocardites - and liquids.
Termination of alcohol intake, any drugs.
Fortifying therapy, vitamin therapy.

Drug treatment:
Etiotropic treatment of myocarditis of Abramov-Fidlera is not developed. Symptomatic therapy of an acute heart failure is carried out.

Surgical methods of treatment:
Refer the following signs to criteria of efficiency of treatment of myocardites -
Good overall health.
Normalization of laboratory indicators.
Normalization or stabilization of an ECG of changes.
Radiographic: normalization or reduction of the sizes of heart, lack of venous stagnation in lungs.
Normalization of cordial activity clinically, and at use of special methods of a research.
Lack of complications and ottorzheniye of a transplant after carrying out transplantation of heart.

The forecast of myocarditis of Abramov-Fidlera - extremely adverse. In acute cases the disease comes to an end letalno within several days, in subacute - within several months.