What is myocarditis? This is an inflammation of the muscular membrane of the heart, which is usually infectious-allergic, infectious and rheumatic in nature. It is quite common, so now it is worth talking in detail about the symptoms of myocarditis, its types, as well as the specifics of diagnosis and treatment.
Etiology
First of all, you should list the reasons due to which this disease overcomes a person. Myocarditis includes a rather large group of diseases of the heart muscle of inflammatory origin, which manifest themselves in damage and dysfunction of the myocardium. The most common causes are:
- Toxins that damage cardiomyocytes (muscle cells of the heart). They are released into the blood by some pathogen in the presence of a systemic infection, and are transmitted directly to the heart. As a rule, diphtheria myocarditis develops for this reason.
- Coronaryitis. This is a syndrome that occurs in rheumatism, dermatomyositis, and lupus erythematosus. He, as well as endothelial vascular dysfunction leads todamage to the heart muscle.
- Non-specific damage to myocardial cells. Autoimmune diseases lead to this, and later myocarditis begins to develop.
- Specific damage to muscle cells. Cellular and humoral immunity factors play a role here, which are activated when a pathogen appears in the body or a primary infection begins to develop.
- Viral diseases. Hepatitis B and C, adenoviruses, herpes, influenza, and Coxsackieviruses spreading in the gastrointestinal tract.
- Bacterial diseases. They are usually provoked by various parasites - rickettsiae, salmonella, diphtheria coryneobacteria, streptococci, chlamydia, staphylococci.
- Fungal diseases. Their development is provoked by candida and aspergillus.
- Parasitic diseases. Their pathogens are Echinococcus and Trichinella.
It should be noted that severe acute myocarditis often occurs with sepsis, scarlet fever and diphtheria.
It also often becomes a consequence of diseases that affect the connective tissue - arthritis, vasculitis, rheumatism, systemic lupus erythematosus. In fact, even the systemic use of heavy drugs, alcohol, and ionizing radiation can cause damage to the heart muscle.
Rheumatic myocarditis
Depending on the cause, there are several types of myocarditis. The first one I would like to talk about is rheumatic. For it to start developing, the following must convergefactors:
- The presence in the body of a pathogenic agent - β-hemolytic streptococcus group A. It has special antigenic properties that are similar to those in the structures of the brain, heart and serous membranes.
- The body's immune response to streptococcal invasion.
- A person's predisposition to disease. Usually the cause is hidden in the family history.
- Sensitization of the body. Under the "onslaught" of streptococci, it can only break down with a second attack. That is why young children are resistant to them.
Symptoms of this type of myocarditis include:
- Pain in the joints.
- Acute attacks of rheumatism.
- Increased body temperature.
- Formation of subcutaneous nodules.
- Chorea. Manifested in irregular, jerky, erratic movements.
- Polyarthritis (joint disease).
- Erythema annulare.
In fact, the symptoms can hardly be called specific. Of the most obvious manifestations, one can note asthenic syndrome, a change from irritability to tearfulness, sleep disturbance. Also, a person is worried about discomfort in the heart area, unexpressed pain, slight shortness of breath and fatigue.
Infectious myocarditis
If there is a failure in a person's immunity, then it will affect all levels - from cellular to phagocytosis. Because the bacteria that provoke the development of the disease change the composition of muscle fibers, as a result of which exudative reactions develop. This gives rise to the growth of connective tissue, and inin the end, everything leads to cardiosclerosis.
If acute infectious myocarditis is left untreated, chronic circulatory failure, poor conduction, and irregular heart rhythms may develop. As a result, everything often leads to death. And in general, 90% of patients in whom a doctor diagnosed this disease receive a disability group.
Specific symptoms, in addition to chest discomfort and heart pain, include:
- Fatigue too fast with little effort. Intense perspiration.
- Persistent palpitations and shortness of breath.
- Feverish conditions.
- Pain in the sternum.
- Joint pain.
- Pale skin.
- Insomnia.
- Constant mood swings.
- Nervous excitement.
- Teary.
In the further stages of myocarditis, severe pain begins to appear, not dependent on stress and physical activity, obvious disruptions in the heart rhythm and tachycardia. At the last stage of development, as a rule, decompensation of the ventricle of the left chamber occurs.
Allergic myocarditis
Telling about this type of disease, it is worth listing several factors contributing to its appearance. The reason can be either one of the previously listed, or:
- Medication taking in large quantities. Abuse of sulfa drugs and antibiotics may well provoke the development of symptoms of myocarditis.
- Vaccinations. Especially at an older age.
- Poisoning with toxic substances.
- Tissue or organ transplant surgery. The highest risk occurs when heart valves are replaced.
No specific symptoms. But those patients who have suffered from this type of disease have impaired immune reactivity. They manifest themselves in neurodermatitis, urticaria, bronchitis, autoimmune pathology and bronchial asthma.
There are also some changes in the body that are not noticed by the armed eye. They can be identified in the following list:
- Decrease in the absorption of oxygen and glucose from the blood.
- Slow down energy production by myocardial cells.
- Metabolic disorders and inactive excretion of metabolic products.
- Changes in electrolyte balance.
After that, cardiosclerosis begins to develop, and connective tissue fibers begin to form in the myocardium.
Abramov-Fiedler's idiopathic myocarditis
Another serious non-specific disease. This acute myocarditis has an unclear etiology, which somewhat complicates the process of diagnosis and treatment. In addition, it has a very high mortality rate. It should be noted that relatively he althy, young people are susceptible to the disease. The average age of patients is 42 years.
The heart muscle of a person affected by this disease has severe degenerative, dystrophic and diffuse inflammatory damage. There are frequent cases of widespread cardiosclerosis, intracardiac thrombosis, embolismarteries.
In many patients, with detailed diagnostics, it is possible to fix flabbiness of the walls, as well as stretching of the heart cavities and variegated color of the myocardium. In addition, hypertrophy of muscle fibers, extensive fields of myolysis and signs of coronaritis - inflammatory infiltrates along the small branches of the coronary vessels are noticeable.
However, this is not all the information you need to know about idiopathic cardiac myocarditis. What it is - in principle, it is clear, but it is also necessary to keep in mind that there is a classification. This type of disease is also divided into four types:
- Dystrophic. The predominance of the processes of hydropic dystrophy of muscle fibers is fixed. in the future, they die totally.
- Inflammatory-infiltrative. It is characterized by swelling of the interstitial tissue and its further infiltration by cellular elements.
- Mixed. It is a combination of the above two types.
- Vascular. It is characterized by damage to the small branches of the coronary arteries.
After a thorough diagnosis of myocarditis, the doctor will be able to establish its exact type and nature of the course. By the way, sometimes there is a latent form of idiopathic myocarditis, which occurs without clear symptoms.
Giant cell myocarditis
This is a very rare disease. But it also deserves attention.
The disease differs from others in that the heart muscle begins to break down immediately, at the first symptoms. And the complications of myocarditis are also not long in coming.
Many patients are already at the initialexamination reveals tissue necrosis, and test results demonstrate the presence of giant multinucleated cells in a large volume.
It is usually diagnosed in patients between the ages of 20 and 45. Most experts are of the opinion that the causes of this disease are associated with autoimmune processes.
What does this mean? In simple terms, the immune system begins to attack the tissues of its own body. And abnormally sized cells are modified macrophages. That is, the once normal cells of the immune system. Initially, they are needed in order to resist inflammatory processes. However, in people with giant cell myocarditis, they regenerate and accumulate in damaged tissues.
Unfortunately, this disease is often asymptomatic. A person can suffer myocarditis and not know about it, since it often develops against the background of an infection, and then its symptoms, taken by the patient as signs of some kind of flu, disappear after recovery. But the disease itself does not disappear.
Diagnosis
ECG for myocarditis is the main way to determine the presence of the disease. With its help, it is possible to examine the heart rate and rhythm, find out about the presence of arrhythmias and extrasystole.
The presence of myocarditis is indicated by transient changes in the ST segment, expressed in an increase or decrease in this segment relative to the isoline. It is often possible to detect prolongation of the QT interval and pathological teethQ.
It should be noted that there are no specific tests to detect the disease, but there are markers that indicate damage to the myocardium of the heart. What is it, we will tell you in more detail:
- Troponins. These are proteins that take part in the process of contraction and relaxation of the myocardium. If their concentration is increased, then it is damaged.
- Antinuclear bodies. They are a sign of lupus myocarditis.
- Creatine phosphokinase MB fraction. It is an enzyme found in brain tissue, skeletal muscle, and heart cells. Its increased amount also indicates myocardial damage.
- Lactate dehydrogenase. Also an enzyme that determines cell damage. This is a non-specific marker, however, in combination with other indicators, it forms the basis for diagnosing the disease.
- Immunoglobulins and circulating immune complexes. They usually indicate the presence of rheumatic heart disease.
Also, with this disease, the heart rate changes. Everyone is individual - for some, the heart rate drops below 50 beats per minute, while for others it increases above 90.
To confirm the symptoms of myocarditis, you need to conduct a laboratory diagnosis. Studying the composition of the blood will help to identify the cause of its occurrence. With viral myocarditis, for example, there is a decrease in the total number of leukocytes and an increase in lymphocytes.
I often refer the patient for echocardiography. Using this method, it turns out to evaluate how the heart valves work, what condition the walls of the myocardium are in,how fast the blood is moving, whether ventricular systolic function is reduced.
Consequences
They are very serious. The worst possible consequence of myocarditis is death. But this is only if a person ignores medical examinations, is not observed by a doctor and is not treated.
Other consequences include dilated cardiomyopathy. This is the name for an increase in the size of the heart muscle, and this occurs as a result of a long course of the disease. And in such cases, not just serious treatment, but heart transplantation is often required.
The treatment of giant cell myocarditis needs to be taken seriously. Most of the patients diagnosed with it need a heart transplant. If transplantation is not carried out, the risk of death increases tenfold. About 90% of patients die within four years.
Drugs
The diagnosis of "myocarditis" can only be made by a highly qualified cardiologist. And only he prescribes the treatment.
The heart is our main muscle, and experimenting by self-prescribing drugs is strongly discouraged. This is dangerous, fraught with serious consequences up to death. In addition, there are many types of myocarditis, and only certain medications help to cope with each of them.
But most often doctors prescribe these drugs:
- Non-steroidal anti-inflammatory drugs. Treatment of myocarditis with their help is obtainedpretty efficient. These funds minimize the production of inflammatory factors, significantly reduce swelling. This group includes such well-known medicines as Ibuprofen, Voltaren and Indomethacin.
- Glucocorticosteroids. They are prescribed for the treatment of severe and moderate myocarditis. They have pronounced anti-inflammatory properties. The most popular drug is Prednisolone, which is administered intramuscularly. Dosage and duration depends on the condition of the patient, the course may vary from 2 to 5 weeks.
- Antiaggregants and anticoagulants. They help prevent platelets from settling in the vessels. "Trental" effectively corrects these violations. They can also prescribe "Heparin", which reduces blood viscosity, which is injected subcutaneously.
Mandatory clinical recommendation: myocarditis greatly weakens the state of immunity and he alth, so you need to use drugs to also support the work of certain systems. In particular, to improve metabolism. Metabolic therapy and drugs such as Adenosine triphosphate, Panangin and Riboxin are aimed at this.
Specific nutrition
It is important to clarify that a diet for myocarditis is a must. First, proper nutrition will help strengthen the heart. Secondly, it helps to improve metabolism, with which this disease causes serious problems, as mentioned above.
So here are some clinical nutrition guidelines to consider for myocarditis:
- Eat enough protein.
- Enrich your diet with foods containing polyunsaturated fatty acids, magnesium, calcium and potassium.
- Refuse s alt.
- Accustom yourself to fractional nutrition - eat at least 5 times a day in small portions.
- Drink fat-free yogurt 2 hours before bedtime.
You will have to exclude the following foods and dishes from your diet:
- Everything that excites the heart and central nervous system: black coffee, strong tea, spices, chocolate, energy drinks.
- Smoked sausages, fatty fish and poultry, meat, kidneys.
- Alcohol.
- Fatty and s alty cheeses.
- Grapes, legumes, white cabbage, radish, mushrooms, sorrel, spinach.
In general, everything that is saturated with fiber will have to be excluded from the menu, as it activates fermentation processes in the intestines, which leads to bloating and adversely affects the work of the heart. And, of course, you need to give up everything fried, canned, s alted, smoked, as well as confectionery and fresh muffins.
Folk remedies
Much has been said above about the history of myocarditis, the specifics of its course and symptoms. Finally, it is worth talking about some effective remedies that help to cope with the disease, which are good because you can cook them yourself. Here are the most popular:
- Take 300 grams of walnuts, dried apricots, prunes and figs. Place in a blender and grind coarsely. You don't have to go to hell. It should turn outcoarse mixture. It must be poured into a jar and poured with liquid honey (100-200 ml should be enough). Mix everything thoroughly and store in a cool place. Consume 1 teaspoon of this heart-he althy blend daily after meals.
- Make a decoction of hawthorn and wild rose over low heat, mixing 0.5 tablespoons each and pouring water (0.5 l). Grind 3 lemons and 200 grams of walnuts, prunes, dried apricots and raisins in a blender. Pour the resulting mixture with decoction and let it brew for 10 days in an opaque container. The resulting porridge is in the morning one spoonful on an empty stomach.
- Fill a 0.5 liter container to the top with fresh lily of the valley buds and pour 70% alcohol. Let it brew for a week, and then strain. Take 60 drops per day, dividing this volume into 3 doses. This tincture has a diuretic, antispasmodic, anti-inflammatory, antiviral, and also a calming effect. It also stimulates the contractile activity of the myocardium.
- Mix fresh strawberries, dried strawberry leaves and loose black tea. All for 1 tbsp. l. Pour boiling water (0.5 l). Insist. Drink like regular tea. This drink is rich in vitamins B1, B2 and B9, nicotinic acid, carotene and ascorbic acid. Helps to remove bad cholesterol, normalize s alt metabolism and strengthen the myocardium.
- Mix valerian root and oregano (2 tbsp each), juniper berries, motherwort herb and fennel (1 tbsp each), peppermint and adonis (1.5 tbsp each). Brew everything with two cups of boiling water, bring to a boil and simmer for 7 minutes over low heat. give the nightinsist, and then drink half a cup 4 times a day. The course lasts 21 days.
And these are just some of the remedies that are considered effective. In fact, there are many more, and if you are interested, you can familiarize yourself with all of them. Many of them are able to eliminate the pain of myocarditis and improve well-being.
