Infectious and toxic myocarditis

Description:

Myocarditis is described as inflammatory infiltration of a myocardium with a necrosis Eli a degeneration of the adjacent myocytes not characteristic of the ischemic damages caused by diseases of coronary arteries. Usually myocarditis is shown at healthy people in all the rest, and can bring to sharply progressing (and often deadly) heart failure and arrhythmia. Myocardites can have a wide range of clinical manifestations, from almost asymptomatic current to heavy heart failure.

Symptoms of Infectious and toxic myocarditis:

More, than at a half of patients with myocarditis the previous virus syndrome - respiratory manifestations, high temperature, headaches is noted. Manifestation of cordial symptoms is observed preferential in a subacute vase of elimination of a virus therefore occurs usually 2 weeks later after an acute viremiya.
Thorax pains.
Stage development of pain in heart (in the first days of a disease pain short-term, then, in several hours or days, it becomes a constant) is characteristic.
Localization of pain in the field of a heart top, in the left half of a thorax or precardiac area.
The nature of pain pricking or pressing.
The constant nature of pain at most of patients (it is more rare happens pristupoobrazny).
More often the intensity of pain moderated (however at a mioperikardita intensity of pain can be considerable expressed).
Intensity of pain usually does not change within a day, and also depending on exercise and emotional stresses.
Strengthening of pain at a deep breath (especially if is available for the patient mioperikardit), rise is often noted the left hand up.
Usually there is no irradiation of pain to the area of the left hand, however at some patients such irradiation is observed.
Asthma at the movement.
Asthma is especially characteristic of the senior age group and of more expressed disease forms. Focal myocarditis can not be followed by an asthma neither at an exercise stress, nor at rest.
Severe forms of myocarditis are characterized by the expressed asthma at rest which is sharply amplifying even at the small movements.
The orthopnea and asthma at rest can be a symptom of heart failure.
Heartbeat and feeling of interruptions in cardiac performance.
Heartbeat and feeling of interruptions in cardiac performance are noted at 40-50% of patients. Arise both at an exercise stress, and at rest, especially at the heavy course of myocarditis.
Feelings of interruptions and dying down in heart are caused by premature ventricular contraction.
At some patients the expressed heartbeat arises pristupoobrazno, is frequent at rest, and is connected with a Bouveret's disease. Often there are disturbances of a cordial rhythm.
Emergence of syncopes can testify to an atrioventricular block of high degree or risk of sudden death.
Dizziness.

Blackout, sharp weakness up to development of unconscious states are usually caused by the expressed bradycardia owing to development of a sinuatrial or total atrioventricular block. More often these phenomena are observed at the heavy course of diphtheritic and viral myocarditis. Sometimes dizzinesses are connected with arterial hypotension which can develop at myocarditis.
Fervescence.
Fervescence is followed by perspiration.
Body temperature usually does not exceed 38 C °.
High fever is observed seldom and is connected, as a rule, not with myocarditis, and with a basic disease against the background of which myocarditis developed.
Arterial pressure at myocardites usually normal.
Development of heart failure.
At development of an acute cordial decompensation:
Tachycardia.
Cantering rhythm.
Mitral regurgitation.
Hypostases.
At development of the accompanying pericardis there can be a pericardial rub.
At gradual development of heart failure:
Bradycardia can be observed.
More expressed temperature increase.
More expressed respiratory disturbances.
Small appetite, or in case of a decompensation perspiration at food.
Cyanosis.

Reasons of Infectious and toxic myocarditis:

Infectious and infectious and toxic reasons:
Viruses: Koksaki type B, adenoviruses, cytomegaloviruses, flu, measles, rubella, mumps, infectious mononucleosis, hepatitis B and C, chicken pox, poliomyelitis, arbovirus, AIDS, etc.
Bacteria: Streptococci (including at scarlet fever), diphtheria, staphylococcus, pneumococci, meningokokk, gonokokk, salmonellas, etc.
Spirochetes: Leptospirosis, Lyme's disease, typhinia, syphilis.
Mushrooms: Candidiasis, actinomycosis, спергилез, кокцидомикоз, etc.
Protozoa: Toxoplasmosis, trypanosomiasis, шистоматоз, etc.
Parasites - the Trichinosis.
Rickettsiae: Q fever, sapropyra, etc.

Treatment of Infectious and toxic myocarditis:

The main attention is paid to causal treatment which is carried out taking into account the revealed or estimated factors (the table, see the paper version of the magazine). At bacterial myocardites appoint antibiotics in usual therapeutic doses. Treatment of viral myocarditis has to be carried out taking into account a phase of pathological process: the 1st phase – replication of a virus; the 2nd phase – autoimmune damage; the 3rd phase – a dilatatsionny cardiomyopathy.
Toxic impact on an organism with clinical signs of myocarditis and defeat of other bodies treat elimination (whenever possible) the agent causing pathological symptoms and use means for stopping of the main symptoms of a disease. The symptomatic treatment is carried out at beam, burn myocardites as specific therapy of basic diseases is not developed.