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Inflammation of the myocardium.



inflammation of the heart muscle (myocardium). Myocarditis may be caused by infectious diseases, including viral ones, and by an allergic reaction, which is the main pathogenic factor in drug-induced and serum myocarditis. The role of autoimmunities and allergies is manifested in postinfluenzal myocarditis, in which the acute infectious disease (influenza) passes but the myocarditis caused by it persists for many months. Contemporary medicine generally accepts the theory that most forms of myocarditis are caused by infections and allergies. Myocarditis is a common symptom of collagen diseases, such as rheumatism, systemic lupus erythematosus, and scleroderma. In South America, Africa, and Polynesia myocarditis may be caused by parasitic diseases. In many cases the cause of myocarditis is unidentified.

Myocarditis may be diffuse or focal. Depending on the course of the disease, cases are categorized as acute, subacute, and chronic (recurrent). Cases may be mild, extremely severe, or fatal. In acute myocarditis patients commonly complain that they feel weak, tire easily, and are short of breath. They suffer from rapid heartbeat (tachycardia), arrhythmia, and pain in the heart. Pallor is also a common symptom. Arterial pressure is low, and venous pressure high, owing to the decreased force of heart contractions. The cervical veins in the neck swell, and the heart becomes enlarged. Various irregularities in cardiac contractions and conduction, to the point of complete atrioventricular heart block, are common and are accompanied by specific electrocardiographic changes. Often there are no clear-cut symptoms of myocarditis, and death occurs unexpectedly from severe injury to the myocardium. Of particular importance in diagnosing such cases are electrocardiography and laboratory tests, including blood count, analysis of protein and protein fractions, determination of enzymic activity, and immunologic studies.

The characteristics of myocarditis vary, depending on the origin of the disease. The most common form, rheumatic myocarditis, is usually accompanied by endocarditis, which results in heart defects. Pain in the heart and irregularities in cardiac rhythm and conduction are the most common symptoms of active rheumatic endocarditis. The causes and developmental mechanisms of idiopathic myocarditis, the most severe form of the disease, are still obscure. Nonetheless, a number of varieties have been distinguished. In one of them, symptoms of cardiovascular insufficiency prevail, accompanied by arrhythmia and the development of pulmonary and renal infarctions and of circulatory disorders in the cerebrum. Another variety is associated with pain in the heart and with EKG changes, and still another, with the development of relative valvular inefficiency due to cardiomegaly. One type of idiopathic myocarditis is manifested by a mixture of symptoms associated with other varieties of the disease.

Diphtherial myocarditis, which occurs in approximately 25–30 percent of all diphtheria patients, usually develops in the second week of the disease. Its most characteristic symptom is disturbance of conduction, to the point of complete atrioventricular heart block. Prompt therapy usually results in recovery, and cardiac disorders persist in only a few patients.

Treatment includes complete rest and the prescription of vitamins (C, B-complex), steroid hormones, and anti-infectious and antiarrhythmic medicines. Salicylates are prescribed in cases of rheumatic endocarditis, and appropriate drugs are prescribed for cardiovascular insufficiency.


Kedrov, A. A. Bolezni myshtsy serdtsa. Leningrad, 1963.


References in periodicals archive ?
Acute myocarditis and focal necrosis of adrenal and corpus luteum tissue was detected.
This (renal failure) had aggravated the acute myocarditis, resulting in acute pulmonary oedema or lung congestion.
This case should alert physicians treating acute myocarditis to a potentially reversible cause of cardiac dysfunction.
The differential diagnosis for ST-SE in the right precordial leads in conditions other than BRS includes anteroseptal myocardial infarction or ischemia, right ventricular ischemia or infarction, early repolarization syndrome, acute pulmonary embolism, dissecting aortic aneurysm, right bundle branch block, left bundle branch block, left ventricular hypertrophy, hyperkalemia, hypercalcemia, arrhythmogenic right ventricular dysplasia/cardiomyopathy, acute myocarditis and pericarditis, tricyclic antidepressants, cocaine intoxication, hypothermia, mediastinal tumors compressing right ventricular outflow tract, right ventricular outflow tract obstruction, various central and autonomic nervous system abnormalities, and Friedreich ataxia.
Tragic Susan was admitted to the hospital 17 days after giving birth but she died three days later from acute myocarditis.
Reye's syndrome associated with acute myocarditis and fatal circulatory failure.
Its application has been extended to several other areas, such as for patients with postoperative cardiogenic shock or cardiogenic shock related to acute myocardical infarction, acute myocarditis, and severe, reversible cardiomyopathy.
This short clinical course suggests, of course, an acute myocarditis that would be characterized by the presence of numerous polymorphonuclear leukocytes in the myocardial walls.
Acute myocarditis versus myocardial infarction: evaluation and management of the young patient with prolonged chest pain--case reports.
She died from acute myocarditis - an infection of the heart - on October 22.
There was also a late gadolinium enhancement of the subepicardial lateral wall (Figure 3), thus confirming the diagnosis of acute myocarditis.

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