Description of the problem:
How is it caused? How is it treated?
Answer:
Myocarditis
Myocarditis refers to acute, subacute, or chronic inflammatory lesions in the myocardium that are limited or diffuse. The relative incidence of viral myocarditis has been increasing in recent years. The severity of the disease is different, the performance varies greatly, infants and young children are more serious, adults are more light, the light can be no obvious symptoms, the heavy can be complicated by serious arrhythmia, cardiac insufficiency and even sudden death.
Acute or subacute myocarditis symptoms, the patient may have fever, fatigue, sweating, panic, shortness of breath, anterior region of the heart boring pain. Examination may reveal arrhythmias such as preterm systole and conduction block. Glutamine aminotransferase and creatine phosphokinase are increased, and blood sedimentation is increased. Electrocardiogram and X-rays help in diagnosis. Treatment includes rest, improving myocardial nutrition, controlling cardiac insufficiency and correcting arrhythmias, and preventing secondary infections.
Viral myocarditis
Information:
EtiologyMyocarditis is a limited or diffuse inflammation of the myocardium, which may be primary in the myocardium or part of a systemic disease. The causes include infections, physical and chemical factors, and medications. The most common cause is viral myocarditis, with enteroviral infections, especially Coxsackie B virus, being the most common.
Clinical manifestations
1, Symptoms: fatigue, fever, chest tightness, palpitations, shortness of breath, dizziness, and in severe cases, cardiac insufficiency or cardiogenic shock.
2. Signs: increased heart rate, disproportionate to the increase in body temperature, enlargement of the heart border, murmur changes, arrhythmia.
Medications
1, the treatment of the primary disease: very critical. Viral infections can be given antiviral drugs, amantadine, 200mg per day; marinoguanidine 0.1g, oral, 3 times a day, with bacterial infections, can be given antibiotics.
2. Symptomatic treatment: bed rest should be given in the acute stage, and only after the symptoms and signs improve and the ECG is normal can the activity be gradually increased, and a nutritious and easily digestible diet be given. The heart function is not enough, arrhythmia, shock should be actively corrected.
3, to promote myocardial metabolism
(1) Vitamin C: 4 ~ 5g added to 250ml of liquid intravenous drip, once a day, 10 ~ 15 days for a course of treatment, can be repeated.
(2) Energy synthesis: ATP20mg + coenzyme A100u + cytochrome C30mg added to 5% dextrose 500ml intravenous drip, once a day, 10-15 days for a course of treatment, can be repeated.
(3) Inosine: 200-400mg orally or intramuscularly, twice daily.
(4) Cyclized adenosine monophosphate (CAMP): 20～40mg, intramuscular injection, twice daily.
(5) Polarizing solution: 10% dextrose 500ml plus ordinary insulin 8u, 15% potassium chloride 10ml intravenous drip, 7 to 10 days as a course of treatment.
(6) Immunosuppressants: used in chronic, prolonged cases. Glucocorticoids: general onset of 10 ~ 14 days does not advocate the application, but if there is high fever, heart failure, severe arrhythmia, cardiogenic shock can be used, can be given to prednisone 40 ~ 60mg, daily tonic, or hydrocortisone 400 ~ 600mg / day, intravenous drip, the condition improves gradually reduce the amount of months 26 weeks after the discontinuation of the drug.
PreventionStrengthen physical exercise, improve the body's ability to resist disease, avoid exertion to prevent viral and bacterial infections. After the onset of the disease, pay attention to rest, enter a nutritious diet, in order to facilitate the recovery of the heart.
Spring to prevent myocarditis
In recent years, due to the widespread use of antibiotics, due to streptococcal infections caused by rheumatic fever is gradually reduced, the incidence of rheumatic myocarditis is significantly reduced, while the incidence of viral myocarditis is increasing. Viral myocarditis can be caused by a variety of viral infections, of which Coxsackie virus B is the most common, chickenpox, EBV can also be caused. According to research, about 5% of viral infections can involve the heart heart myocarditis after infection. It can be caused by direct invasion of the myocardium after viral infection, or by autoimmune reaction after viral infection. The former is more common in children and the latter is more common in adolescents. The spring is the high season of viral myocarditis, should cause people to be vigilant.
At the beginning of the disease and upper respiratory tract infection or intestinal infection symptoms, 7-10 days after the emergence of chest tightness, palpitations, extreme fatigue, easy to sweat and other symptoms. At this time, if the electrocardiogram is done, it may be found that there are premature beats and other cardiac arrhythmias and myocardial damage manifestations. Blood sedimentation, cardiac enzymes may be elevated. 2-4 weeks after the detection of coxsackievirus antibodies, anti-cardiac antibodies can be positive.
The severity of viral myocarditis varies, and so do the symptoms. Mild, limited lesions can be asymptomatic, with no abnormalities on the electrocardiogram, and no elevation of blood sedimentation or cardiac enzymes. In some cases, the presence of myocarditis is only recognized at autopsy after an accident. In severe cases, there are obvious symptoms, diffuse cardiac enlargement, heart failure, so that there is a significant shortness of breath, can not lie down; some serious arrhythmia, so that repeated fainting, and even sudden death.
Studies have shown that viral infection is still persistent tension, overwork, heavy labor and strenuous exercise, prone to viral myocarditis. In addition, malnutrition is also a trigger. After the occurrence of viral myocarditis, must be absolutely bed rest, otherwise the condition can be aggravated, causing serious complications.
After the viral myocarditis, generally should rest for 3 months. Later, if there are no symptoms, you can gradually resume work and normal study, but still should pay attention to do not exertion, 1 year can not engage in physical labor and exercise. In addition, it is necessary to pay attention to a reasonable diet, eat more fresh vegetables and fruits to ensure nutritional balance. Ensure enough sleep and rest, and avoid catching a cold, otherwise it is easy to relapse. Repeated episodes can be transformed into chronic myocarditis, cardiomyopathy, harm lifelong.
Treatment of myocarditis and cardiomyopathy
Currently, the treatment of myocarditis and cardiomyopathy in Western medicine is not ideal. There are no effective antiviral drugs for patients with viral myocarditis. For chronic myocarditis patients with arrhythmia treatment is not good. The cause of cardiomyopathy is still unknown and there is no good treatment. Myocarditis and cardiomyopathy are diseases that jeopardize people's health and are not easy to treat. From the therapeutic effect of Chinese medicine in treating these cardiomyopathies over the years, the situation is promising. We can increase the efficiency of Chinese medicine in treating these diseases. Reduce the mortality rate. Reduce the after-effects. Improve the patient's quality of life has obvious advantages.
The most effective adjuvant treatment for cardiovascular diseases: Zengjian oral liquid + seal oil capsule
There is no special treatment for viral myocarditis, and the main comprehensive treatment measures. As a parent of a child, you should actively cooperate with the doctor's treatment, and pay attention to the care of life.
For any disease, prevention is more important than treatment. To prevent viral myocarditis, we should first prevent colds and intestinal viral infections, often participate in physical exercise to improve the body's ability to resist disease, and often open the windows of the room to keep the air fresh. In the season of cold and flu, we should minimize going to crowded places and pay attention to preventing various viral infections. Once you find a viral infection, you should pay attention to adequate rest and avoid excessive fatigue.
Toxic myocarditis
I. Overview
Toxic myocarditis refers to myocardial inflammation caused by toxins or poisons, in addition to diphtheria, typhoid fever, bacillary dysentery and other infectious diseases exotoxins, endotoxins on the myocardial damage, certain biological toxins such as snake venom, poisonous mushrooms, puffer fish, aconite, etc., as well as certain medications or chemicals such as quinidine, quinine, emetine, antimony, organophosphorus, organomercurial, arsenic, monoxide and other substances. Organic mercury, arsenic, carbon monoxide, lead, enzyme, etc., can cause myocardial damage and produce toxic myocarditis. Toxic myocarditis is often an important part of the manifestation of systemic poisoning, the condition is critical or complication of severe cardiac insufficiency and arrhythmia of the mortality rate is high, timely and effective rescue is often able to save the patient's life.
I. Symptoms
1 . Symptoms of cardiac insufficiency, such as palpitations, shortness of breath, body and pulmonary circulation stasis signs;
2. Arrhythmic performance.
II. Diagnostic basis
1. Toxins or poisons through the skin mucous membranes, gastrointestinal tract or respiratory tract and other evidence of entry into the body;
2. The presence of cardiac insufficiency, arrhythmia clinical symptoms, supplemented by laboratory tests, can be diagnosed.
Third, the principle of treatment
1. Immediately terminate the poison or toxin continues to enter the body, and promote its excretion;
2. The use of antidotes or antagonists;
3. Improve the myocardial metabolism and nutrition;
4. Prevention and treatment of cardiac insufficiency and arrhythmia;
5. Symptomatic treatment.
Fourth, expert tips
The disease is mainly due to toxins or poisons through the skin mucosa, gastrointestinal tract, respiratory tract, etc. into the body, caused by myocardial damage. In addition to diphtheria, typhoid fever, bacillary dysentery and other infectious diseases of internal and external toxins on myocardial damage, snake venom, mushrooms, organophosphorus poisoning is common in rural areas; antimony, mercury, arsenic, lead poisoning is easy to occur in the industrial pollution zone; puffer fish, carbon monoxide poisoning in the towns and cities from time to time; there are certain drugs such as quinine, emetine, aasein and other myocardial damage caused by the. Therefore, it is very important to raise public awareness of poisons and prevent them from entering the body. Once poisoning occurs, the poison or toxin should be terminated immediately to continue to enter the body, out of contact with the poison or toxin, using the cleaning of the skin and mucous membranes, inducing vomiting, diarrhea and other methods to promote its excretion, and quickly sent to the hospital for rescue, timely and effective treatment is often able to save the patient's life, or else the consequences will be serious. For toxic myocarditis, improve myocardial metabolism and nutrition, prevention and treatment of cardiac insufficiency and arrhythmia, is the main content of the treatment