Tonzillogenny cardiomyopathy
Contents:
Description:
It the changes of heart arising at an adenoid disease. Tonzillogenny damages of heart can proceed in the form of a so-called functional cardiopathy and more serious changes — dystrophies of a myocardium and myocarditis. At all these states symptoms of the expressed tonsillitis inclined to frequent aggravations are found in patients. The disease arises usually at young people (preferential up to 30 years), is more often at women.
Symptoms of the Tonzillogenny cardiomyopathy:
The first symptoms appear in most cases gradually, is more rare in a direct connection with an exacerbation of tonsillitis. The most frequent complaint — pain in heart of various character and intensity, often acute, pricking, not connected with an exercise stress. Sometimes there is asthma at loading, interruptions in cardiac performance are noted heartbeat. There can be other signs of a neurangiosis (see), and also arthralgias, not izchezayu-shchy from reception of acetylsalicylic acid. At an object research regarding cases practically do not find any deviations of a so.storona of heart and laooratorny indicators (a functional cardiopathy) at all. Other patients can have a long subfebrile condition, bent to tachycardia, hypotonia, an insignificant cardiomegaly to the left, a priglushennost of tones, a small systolic apex murmur, insignificant shifts of the separate laboratory indicators used for definition of activity of rheumatic process (increase in SOE, a leukocytosis, increase in credits of antistreptolysin Oh, in an antistreptogialuronidaza, S-reactive protein, difenilaminovy test). All this is characteristic of the tonzillogenny dystrophy of a myocardium proceeding for years without big progressing and development of heart failure. At tonzillogenny myocarditis symptoms of defeat of cardiovascular system are expressed more sharply, than at myocardium dystrophy. In addition to tachycardia, dullness of cardiac sounds, systolic noise, there can be also clear changes on an ECG in the form of disturbances of conductivity, premature ventricular contraction, changes of a segment of ST, the T tooth. Existence of inflammatory process is confirmed by clearer change of laboratory tests.
Differential diagnosis of the mentioned tonzillogenny damages of heart with inertly proceeding primary rheumatic carditis is quite often very difficult and has to be based on the complex analysis of clinical, laboratory and tool data. In general the combination of various, often very motley complaints is more characteristic of these defeats, especially cardialgias with small expressiveness of objective displays of a disease which besides are not inclined to essential dynamics and are never followed by development of heart disease or a pericardis.
Reasons of the Tonzillogenny cardiomyopathy:
The main etiologichesy factor - the tonsillitis postponed in the anamnesis.
Treatment of the Tonzillogenny cardiomyopathy:
Treatment of tonzillogenny damages of heart is carried out by the therapist together with the otolaryngologist. Begin with conservative therapy of tonsillitis,
which is appointed by the otolaryngologist. In the absence of effect and progressing of changes from heart the tonsilectomy is shown. At a functional cardiopathy at the same time appoint calmatives (a valerian, a hawthorn, Corvalol, etc.). At dystrophy of a myocardium vitamin therapy, periodic administration of ATP and cocarboxylase are shown (20 — 30 injections on a course of treatment). After a tonsilectomy dispensary observation for such patients within 2 years is necessary. At tonzillogenny myocarditis treatment is carried out the same as at a rheumatic carditis.
