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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 ?
Coxsackie B viral myocarditis and valvulitis identified in routine autopsy specimens by immunofluorescent techniques.
Coxsackievirus B3 (CVB3), a member of the Picorna-viridae family that contains a single-stranded and positive-sense RNA genome, causes viral myocarditis, and can further develop into dilated cardiomyopathy in humans (Pauschinger et al.
Pathologist Dr Adrian Warfield said viral myocarditis was a "sporadic, unlucky infection" that strikes young and healthy people, with an average age of 42.
Viral myocarditis is relatively common and most cases are very mild and may never come to the attention of the doctor or are never detected clinically.
Doctors at HSC see approximately 12 cases of viral myocarditis annually.
With early enough detection and intervention for viral myocarditis, in the form of circulatory or cardiac assist devices, we not only preserve the lives of these patients, but we can actually allow their hearts to rest and recover function in almost every case," said Don Botta, MD, Yale New Haven Hospital.
Just today I saw James, a patient who is likely to need a heart transplant, who told me his previous doctor did not recognise viral myocarditis and his heart was seriously affected.
The use of this device allows patients' hearts to rest and recover following events such as acute myocardial infarction (AMI or heart attack) or viral myocarditis.
The patient responded within 12 days to clozapine but on the 12th day developed symptoms that suggested either acute viral myocarditis or a hypersensitivity reaction to the drug.
He explained that Julie's heart had been attacked by a rare virus called viral myocarditis - a one-in-a million chance - and was giving out.
Abiomed's technology has benefited patients around the world and was highlighted by a viral myocarditis patient who recovered the native function of his heart following bi-ventricular circulatory support with an Abiomed VAD.