DISEASE OF BODIES OF BLOOD CIRCULATION : AN ACUTE INFECTIOUS MYOCARDITIS (MYOCARDITIS ACUTA INFECTIOSA) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Кровеносная система, сердце, сосуды, кровь
Any infection can cause damage to the heart muscle, however, for some diseases (diphtheria, scarlet fever, typhoid fever, typhus fever, septic processes), as well as in rheumatoid arthritis is characterized by a peculiar course of painful process. The term myocarditis is saved, although mainly in most forms prevail parenchymal changes (sharp degeneration of the heart muscle); inflammatory reactions (round-cell infiltration, exudate, vascular events in interstitial tissue) fade into the background; however, in some ways they precede the degeneration of the muscle fibers. Diphtheria is an acute myocarditis develops in more than 1/3 of all cases and causes significant changes in the muscle fibers, which are later replaced by fibrous tissue. Characterized by the involvement in the process and wiring systems. Beginning of the disease usually falls on the end of the first week of diphtheria, by the end of the second week reaches its maximum and only slowly (within 4 - 5 weeks) quiets down. With scarlet fever and typhoid fever are similar pathological findings, only much less pronounced and relatively quickly discontinued. When true rheumatism, very often complicated by myocarditis (15%), described located in the interstitial tissue (in connection with adventitia vessels) a kind of accumulation of cells (nodules)that are mandatory companion rheumatic infection and have some development cycle, lasting 4 to 6 months and ending sclerosis allasosasto tissue (Talalaev). Muscle fibers part affects the primary part perish from the developing sclerosis. Wiring system may also be involved in the disease. Rheumatic myocarditis often combined with the defeat of the endocardium, and sometimes pericardium. When typhus are mainly affected vessels of the skin, brain, and partly heart with secondary changes in the myocardium. Toxic-bacterial effect on the myocardium with staphylococcal, streptococcal pneumococcal, gonococcal and influenza infection gives little characteristic patterns. If septicopyemia in the heart muscle can produce greater or lesser magnitude abscesses, which, breaking into the cavity of ventricles or shirts, lead to ulcers and heart purulent pericarditis the.
Suddenly there comes a severe General condition; the patient complains of chest tightness, sometimes to severe pain; pale skin, with a bluish tinge (acrocyanosis); the heart is enlarged, the colours are deaf, there is embrionaria (extension of systole and shortening of diastole), gallop rhythm, the pulse gradually quickens and becomes irregular (pulsus inaequalis), and then sometimes intermittent (pulsus alternans on). In connection with the violation of conductivity can receive the loss and then shall be heard atrial form gallop rhythm, sometimes defined interruptions (PVCs). Electrocardiogram allows to judge about masterabation affection of cardiac muscle. If blockade feet heard ventricular gallop rhythm. Change teeth P points to defeat fibrillation (more common for diphtheria and typhoid fever). Prong T undergoing a kind of deformation (tifa and rheumatism, pointing to the defeat of the muscles of the ventricles. Blood pressure is usually reduced. The symptomology is complicated by the presence of a certain phase of infectious diseases, during which develops acute myocarditis (tachycardia due to temperature, weakness and other).
Determined by the nature of the infection and the severity of the General condition. Objective signs of serious importance is the emergence of the intermittent pulse. From other forms of arrhythmia extrasystoles indicate a continuing process in the myocardium; atrial and atrio-ventricular extrasystoles prognostically important, because indicate significant anatomical damage; of serious ventricular the left than the right. Persistent blockade and atrial fibrillation often accompany chronic affections of the heart muscle (see Arrhythmia).
myocarditis is primarily the prevention of infections, then timely vigorous treatment and care of patients.
At detection of symptoms of myocarditis compulsory full physical and mental peace (bed content) depending on the severity of injury for 3-6 weeks. Myocarditis after diphtheria off the bed and move to a particular activity should with extreme caution, as they may develop serious and sometimes terrible events (mors subita) even after 1-2 months of onset.