DISEASES OF CHILDHOOD : ENDOCARDITIS(ENDOCARDITIS) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
At an older age often rheumatic infection developing in connection with the focal, usually oral infection (tonsillitis, quinsy). Much less scarlet fever and other acute infections; septikopiemicheskoy processes in infancy. Have the value of individual susceptibility to rheumatoid arthritis and social conditions. Predisposes to disease congenital heart defects.
Symptoms. Atypical fever, pallor, cyanosis, increased heart rate, reduced first sound at the apex, the noise (infants often do not have time to appear) and progressive change, signs of heart weakness. Often accompanied by polyarthritis, chorea.
For. The acute phase lasts 4 to 10 weeks.
To exclude myocarditis, sepsis. Cupping test Waldman, sample Buchstabe-Yasinovka, intradermal test with sodium salicylate are auxiliary.
The prediction is relatively satisfactory. The outcome is a chronic organic heart disease; at an early age often sepsis, including fatalities.
Favorable conditions of life, a thorough treatment of angina, sanation of an oral cavity, hardening, special care after the first attack of rheumatic infection.
Acute endocarditis requires complete physical and mental rest, light food, take small portions and lying; cold on the heart. In a period of increased temperature on the inside of salicylic drugs. When you anxiety - bromides, luminal. With symptoms of weakness, cardiac activity, caffeine, camphor, Adonis, digitalis (both of the latter drug is contraindicated in the phenomena of conduction disturbances). In severe cases with persistently keeping the temperature of intravenous administration of 1 - 5 ml of 40%+. Penicillin in large doses - up to 1.5 million units per day (weak effect in rheumatic etiology). With compensated disease, heart drugs unnecessary. The correct way of life, moderate exercise, avoid physical and mental fatigue, favorable conditions of life, preservation of opportunistic infections - the main elements of prevention of this period. Decompensated heart blemish - treatment, as described above in heart failure. When edema is useful to combine heart with diuretics (diuretic).