Rheumatic myocarditis is characterized by damage to the muscular membrane of the heart, and the disease develops against the background of rheumatism. When the first signs of illness appear, you should definitely visit a doctor for diagnosis and treatment.
Rheumatic myocarditis is always due to a rheumatic attack. This form of the disease is characterized by the fact that the main complaint of the patient is pain in the region of the heart. Painful manifestations are permanent, dull. Basically, they are long-term, occur periodically and intensify with physical activity.
Rheumatic myocarditis is characterized by the fact that it occurs with a violation of the rhythm and conduction of the heart. Cardiovascular insufficiency develops only in the most advanced cases.
Basic shapes
There are several forms and types of rheumatic myocarditis, among which are the following:
- spicy;
- fleet;
- chronic persistent;
- chronic active.
Acute rheumatic myocarditis develops very quickly, often leading to arrhythmias andheart failure. In some cases, the disease is fatal. The transient form of myocarditis provokes a violation of the functionality of the left ventricle of the heart, which is accompanied by the destruction of its cells and cardiogenic shock.
Chronic persistent form of the disease is characterized by the fact that the work of the heart muscle is fully preserved until the transition of the disease to the stage of active borderline myocarditis. At the initial stages of development, there are no pronounced symptoms, as a result of which complications may arise and heart failure may appear. It is impossible to eliminate it even after stopping the inflammation.
Chronic active stage of rheumatic myocarditis combines signs of acute and transient forms. There is a high risk of developing cardiomyopathy. Foci of inflammation may persist after complete recovery. Sometimes the disease is complicated by fibrosis, which is accompanied by pathological tissue growth, as well as scarring.
The chronic form appears in the absence of timely diagnosis and treatment of acute manifestations of pathology. In a chronic course, the disease is recurrent in nature, aggravated against the background of the development of viral diseases and the presence of many other provoking factors.
Classification by symptoms
There are different types of rheumatic myocarditis, differing in clinical manifestations, namely:
- polysymptomatic;
- pain;
- arrhythmic;
- pseudo-valve;
- decompensatory;
- thromboembolic;
- mixed.
The asymptomatic form is characterized by the fact that the patient is worried about slight weakness, fatigue, but there are no signs of heart disease. With pain, the appearance of pain in the sternum is characteristic. They can be of a different nature and resemble ischemia.
With the decompensation type, there are signs of circulatory disorders. Puffiness appears, and the skin may also become bluish in color. The arrhythmic form of myocarditis is caused by a violation of the heart rhythm. It could be an arrhythmia or bradycardia.
Thromboembolic type of disease is characterized by the fact that with this type of myocarditis there is a possibility of a blood clot in the pulmonary artery and blood vessels. With pseudovalvular myocarditis, deformation of the valves of the heart muscle occurs, which manifests itself in the occurrence of heart murmurs. The mixed type can have signs of all types of the disease.
Main reasons
Rheumatic myocarditis is a rather complex pathology that occurs a few days after a previous infectious disease. Initially, the joints and soft tissues are affected by streptococci. Among the main factors influencing the development of the disease, it is necessary to highlight the following:
- specificity of the antigenic properties of streptococcus;
- the body's response at the immune level to the presence of bacteria;
- genetic predisposition;
- frequent attack by pathogens.
All these provoking factors lead to the development of systemicdiseases, in particular, such as rheumatism, against which rheumatic myocarditis develops. Usually, the infection affects all tissues of the heart.
This disease can manifest itself as a complication of an infection, for example, influenza, tonsillitis, chlamydia, scarlet fever, herpes. The most severe forms occur against the background of sepsis.
Main symptoms
Symptoms of rheumatic myocarditis can come and go intermittently. Often the disease does not have any pronounced symptoms until the onset of complications. Among the main symptoms of rheumatic myocarditis are the following:
- pain;
- shortness of breath;
- slight rise in temperature.
The leading clinical symptom of rheumatic myocarditis is pain in the region of the heart. It is worth noting that it is very rarely intense. Basically, it is aching, pulling, mild and does not cause very strong anxiety in patients. In addition, a person may also be disturbed by aching joints.
With myocarditis, shortness of breath is not very strong and occurs only during physical exertion, so a person does not always pay attention to the presence of a problem. If shortness of breath occurs at rest, then you should definitely visit a doctor for a complete examination. During the course of the disease, the temperature can rise to 38 degrees and stay for a long time. With a sluggish infection, the temperature rises slightly.
In case of myocarditis, all these signs may appearor just a part of them. The clinical picture largely depends on how much the infection has spread, and where exactly it is localized. In the initial stages, the disease is almost asymptomatic.
What the patient looks like
The appearance of a patient with myocarditis largely depends on how the disease proceeds, as well as on its severity. With a mild course and at the initial stage, the patient is practically indistinguishable from a he althy person, since he is only worried about general weakness. As the disease progresses, with its moderate course and in the advanced stage, a person has a pale skin tone, and the fingers and lips turn blue.
With the decompensated form, swelling of the veins in the neck is clearly visible, which is especially noticeable during physical exertion. When walking, marked shortness of breath is noted, which causes a person to periodically stop to rest. This form is characterized by the appearance of edema of the legs. If any of these signs occur, see a doctor.
The first signs of pathology can appear 3-8 weeks after the course of any infectious disease. It could be a cold, the flu, a sore throat.
Diagnostic measures
In rheumatic myocarditis, the diagnosis is rather difficult, since specific signs may be absent for a long time. Diagnostics consists of the following steps:
- gathering anamnesis;
- lab test;
- instrumental examination.
Initially, the doctor collects an anamnesis, talks to the patient,finds out what complaints are, the reasons for their occurrence, as well as the nature of the change in symptoms over time. Particular attention is paid to previous illnesses, especially in the case of bacterial and viral infections.
Examination of the patient is aimed at determining signs of heart failure, such as swelling of the legs, shortness of breath, cyanosis of the skin, swelling of the veins in the neck. Then the doctor listens to the lungs and heart. With myocarditis, the presence of muffled tones is noted. On the part of the lungs, there is often a weakening of breathing as a result of the fact that blood stagnation occurs.
Percussion means that the doctor performs tapping to determine the boundaries of the heart. Laboratory and instrumental examination is considered a very important diagnostic step, as this allows you to accurately determine myocarditis, if any. For this, the following types of examinations are shown:
- electrocardiogram;
- pressure measurement;
- ultrasound diagnostics;
- radiography;
- tomography;
- scintigraphy;
- blood and urine tests.
Different specialists are involved in the diagnosis of this disease, in particular, rheumatologists, cardiologists, radiologists. Of great importance in rheumatic myocarditis is a micropreparation of the heart, since it is possible to determine an increase in the size of the heart muscle. In this case, the myocardium becomes weaker, and the valve leaflets are thickened. Only then can a correct diagnosis be made.
Featurestreatment
In the acute period of the course of the disease, the patient must be hospitalized in a hospital, regardless of whether the pathology first appeared or this exacerbation. The patient is required to limit physical activity, so it is important to observe bed rest. All these activities are aimed at reducing the load on the heart and compensating for cardiac activity.
During therapy, it is very important to follow a special diet, which implies:
- liquid restriction;
- reducing the amount of s alt;
- exclusion of fried foods, smoked meats, pastries, meat.
Treatment of myocarditis is aimed at eliminating the causative agent of the disease, the cause of inflammation and the main symptoms. The appointment of antiviral agents, antibiotics is carried out only if the presence of the corresponding pathogen in the body is suspected. In this case, it is imperative to exclude all signs of a chronic infection in the body.
When prescribing antibacterial agents, it is desirable to initially determine the sensitivity of the pathogen to these drugs. You can eliminate inflammation with the help of glucocorticosteroids, anti-inflammatory and antihistamines. To eliminate the external signs of the disease, anticoagulants, antiarrhythmic drugs and drugs to increase blood pressure are prescribed.
During therapy, it is imperative to support the myocardium, therefore, doctors prescribe drugs that stimulate metabolism and normalize the nutrition of the heart muscle. Definitely need vitamin complexes. The duration of treatment is approximately 4 months, and after that a course of rehabilitation is required.
Folk techniques
Folk remedies are only an auxiliary therapy in the treatment of this disease. They can be used with the permission of a doctor, so as not to provoke a deterioration in well-being. Among folk remedies, doctors distinguish the following:
- garlic;
- herbal preparations;
- birch sap.
Garlic is considered one of the most beneficial foods for the heart muscle. The substances contained in it help prevent heart attacks and blood clots. It can be taken fresh or made into an infusion. With myocarditis, the following plants will be useful:
- hawthorn;
- fennel;
- horsetail;
- motherwort.
These herbs can be infused and taken in small portions throughout the day. Natural birch sap helps to strengthen the myocardium and eliminate swelling. To prepare the medicine, you need to mix birch, lemon juice, and honey.
Folk remedies have a cumulative effect, in order to achieve a positive result, you need to take them in courses and strictly observe the dosage.
Features of the disease in childhood
Rheumatic myocarditis in children is characterized by a diffuse appearance of the affected myocardium, which leads to congestive processes in the circulatory system. Children get sick much more often than adults, since their immunity is not yet fully formed. Tothe development of pathology lead to frequent diseases provoked by streptococci. This may be due to the flow of inflammation in the body.
Foci of chronic infection can provoke the onset of the disease, which leads to sensitization of the body. Also an important role in the violation of the immune system is played by overwork, hypothermia and malnutrition. Outbreaks of acute rheumatic fever may be due to the misuse of antibacterial drugs.
Among the symptoms of rheumatic myocarditis in children is difficulty breathing, fever, chills and even fainting. In addition, there may be pain in the sternum. The leading clinical symptom of rheumatic myocarditis in children is pain in the joints, as well as the presence of aching pain in the heart.
During therapy, bed rest is required. As a drug treatment, antibacterial agents and anti-inflammatory drugs are used. With incorrect or untimely therapy, various kinds of complications can develop.
Possible Complications
Myocarditis can lead to many different consequences. Its course depends on the characteristics of the organism, immunity, as well as the stage of development of the disease. Complications can affect the heart and other organs. The most common consequences of myocarditis include:
- thromboembolism;
- ascites;
- heart failure;
- cardiosclerosis.
Ascites is characterized by the accumulation of fluid in the abdominal cavity. In this case, the stomach increases in size, there is a feeling of heaviness and fullness. Thromboembolism is a serious condition in which a clot clogs a vessel or artery. At the same time, blood circulation is disturbed, various complications develop. If the clot breaks off, it can lead to secondary blockage of the artery and death of the patient.
With cardiosclerosis, scar tissue is formed, which eventually grows and reduces the contractility of the heart. The most dangerous complication is heart failure and sudden cardiac arrest.
Prevention and prognosis
Proper nutrition and a he althy lifestyle can protect the heart from various kinds of diseases. With timely treatment, the prognosis is quite good. Many suffer this disease without complications. With the wrong treatment, the pathology can become chronic. In this case, relapses will alternate with remissions.
When the disease is severe, it can lead to heart failure, which increases the risk of death. To prevent the development of myocarditis, you need to adhere to the basic rules of prevention, which includes:
- hardening;
- proper nutrition;
- timely treatment of infectious diseases;
- giving up bad habits.
All these preventive measures help not only prevent the development of myocarditis, but also many other diseaseshearts.
