One of the necessary conditions for the normal functioning of all organs and systems of the body is a painless vital activity of the heart. Among the many diseases that affect the heart, one of the most dangerous ailments is myocarditis, accompanied by inflammation of the myocardium (cardiac muscle).
Myocarditis can be divided into primary (isolated idiopathic myocarditis) and secondary one (developing against other diseases).
In regards to etiology, secondary myocarditis can be:
- on the background of other diseases.
By prevalence, myocarditis can be diffuse and focal.
By the nature of the course it can be acute, subacute, chronic recurrent and progressive.
There are many different etiological factors of myocarditis:
- viral infections;
- fungal lesions;
- bacterial infections;
- parasitic infestations;
- systemic diseases of connective tissue;
- allergic diseases;
- toxic effects.
Clinical manifestations depend on the severity of the process, its etiology and degree of myocardial damage. The main symptoms are fast fatigue, severe weakness, excessive sweating, possibly raising of the body temperature to subfebrile figures, shortness of breath with physical exertion, rhythm disturbances (palpitation, tachycardia, irregular heartbeat), aching pain in the heart, lowering blood pressure and pain in the joints. Thromboembolism can occur over a large and small circle of circulation in severe idiopathic myocarditis. Infectious one can occur asymptomatically against a background of general intoxication. There is a predominance of certain symptoms depending on the cause and severity of the process.
It is very difficult to diagnose myocarditis. It is caused not only by the latent course of the disease, but also by the lack of clear criteria for pathology in doctors.
Diagnostics includes the following:
- laboratory blood tests;
- X-ray of the chest (possible expansion of the boundaries of the cardiac shadow and the presence of signs of stagnation in the lungs);
- isotope study (visualization of damage zones);
- MRT, positron emission tomography of the heart;
- endomyocardial biopsy (inflammatory cell infiltration, necrosis and damage to myocardiocytes, etc.).
This dissease, regardless of the cause that provoked it, generally has similar elements. This is due to the fact that with any myocarditis inflammation of the heart muscle occurs and there is an inadequate response of the immune system to inflammation, which leads to the death of cardiomyocytes and the development of myocardial cardiosclerosis. The enumerated set of factors determines the tactics of therapy.
Treatment in a hospital can last from 3 weeks to 2 months, depending on the patient’s state of health.
At this time, it is necessary to realize three global goals:
- carry out a medication correction;
- eliminate foci of chronic infection;
- start the physical rehabilitation of the patient.
With regard to drug treatment of myocarditis, it involves the appointment of anti-inflammatory drugs and ones that affect the cause that led to the development of the disease (etiotropic therapy). In addition, the reception of antihistamines, disaggregants, agents that reduce the activity of sympathoadrenal and renin-angiotensin-aldosterone systems is indicated.
Prolonged myocarditis leads to cardiac arrhythmias and heart failure, which can cause sudden coronary death.
It is recommended to carry out timely sanation of inflammation sites in the body, prevention of helminthic invasions and treatment of concomitant pathology.