Cardiology: Myocarditis — Differential diagnosis and conservative treatment. Treatment
Myocarditis is a dangerous disease characterized by inflammation of the heart muscle. The causes of myocarditis can be infectious agents, toxic effects, rheumatism and allergic conditions. According to statistics, up to 10% cases of myocarditis are not diagnosed because of unclear clinical picture and complexity of diagnostics.
Establishing a correct diagnosis is not an easy task. This is primarily due to the lack of pathognomonic signs, unequivocally indicating an inflammation in the myocardium. A comprehensive assessment of the case history, physical examination and findings of high-tech examination methods allow the experts to establish the diagnosis and cause of inflammation in a timely manner. The following methods are used to diagnose the myocarditis:
- ECG: reveals non-specific violations;
- echocardiography: characterizes the size of each section of the heart and mobility of its walls;
- blood tests: biochemical, complete, immunological, PCR;
- X-ray: visualizes the size of the heart and complications of the respiratory system;
- myocardial biopsy: performed by sensing;
- scintigraphy: identifies infiltration and swelling of the heart muscle;
- MRI with contrast;
- Bacterial inoculation.
Myocarditis treatment is aimed at compensation of cardiac activity, subsidence of inflammatory process and removal of etiological factor of the disease. The treatment requires hospitalization, compliance with therapeutic regimen and dietary recommendations. The plan of therapeutic measures is adjusted depending on the dynamics of the patient's condition.
- Antibacterials are prescribed via the parenteral route, taking into account the sensitivity identified during the bacterial inoculation. When a myocarditis connection with other centers of infection (sinusitis, otitis, stomatitis) is established, they are simultaneously treated according to standard protocols.
- Antivirals are used for the viral nature of the disease.
- Anti-inflammatory drugs reduce swelling and improve the general condition.
- Antihistamines are indicated particularly upon allergic origin of myocarditis.
- Immunocorrectors are used in rheumatic processes.
- Corticosteroid hormones are indicated for severe cardiac decompensation.
- Metabolic correctors.
- Cardiac glycosides, diuretics, antiarrhythmics support the heart work.
- Antithrombotic agents prevent the thromboembolic complications.
A proper approach to treatment of myocarditis, the use of modern effective drugs and attention to the disease peculiarities in a particular patient in most cases allow to count on a favorable outcome.Hide
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