Myocarditis

Heart Muscle Inflammation (Myocarditis): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing) due topossible: Skin [pallor] Neck vein congestion? Edema (praetibial edema?/water retention in the area of the lower leg/before the tibia, ankle; in supine patients: presacral/before the … Heart Muscle Inflammation (Myocarditis): Examination

Heart Muscle Inflammation (Myocarditis): Test and Diagnosis

A therapy-relevant diagnosis can only be made myocardially (infectious or noninfectious myocarditis), taking into account the biopsy guidelines! All patients with etiologically unclear heart failure (cardiac insufficiency) must be clarified myocardially by myocardial biopsy.Laboratory parameters 1st order – obligatory laboratory tests. Small blood count [leukocyte count ↑ if applicable] Differential blood count Inflammatory parameters – … Heart Muscle Inflammation (Myocarditis): Test and Diagnosis

Heart Muscle Inflammation (Myocarditis): Drug Therapy

Therapeutic Targets Improvement of the symptomatology Avoidance of complications Healing of the disease Therapy recommendations The most important measure is physical rest! Viral myocarditis (about 50% of cases): virostatic therapy with gan-/valaciclovir; so far only performed in controlled studies in human herpesvirus type 6A/B, cytomegalovirus (CMV), Epstein-Barr virus, EBV) in progressive courses. Interferon-α/β achieves good … Heart Muscle Inflammation (Myocarditis): Drug Therapy

Heart Muscle Inflammation (Myocarditis): Diagnostic Tests

Obligatory medical device diagnostics. Electrocardiogram (ECG; recording of the electrical activities of the myocardium) – as a standard diagnostic test [“infarct-like” ECG changes, especially ST-segment depression; T-negativations; conduction disturbances and extrasystoles] Note: ST-segment changes or T-negativations are detectable in less than 50% of patients in the early stages of myocarditis. Echocardiography (echo; cardiac ultrasound)-as a … Heart Muscle Inflammation (Myocarditis): Diagnostic Tests

Heart Muscle Inflammation (Myocarditis): Prevention

To prevent myocarditis (heart muscle inflammation), attention must be paid to reducing individual risk factors. Behavioral risk factors Stimulant consumption Alcohol Drug use Cocaine Environmental pollution – intoxications Arsenic Lead Lithium Prevention factors (protective factors) After infections-even those in which there is no fever or only a low fever-one should take at least a week’s … Heart Muscle Inflammation (Myocarditis): Prevention

Heart Muscle Inflammation (Myocarditis): Or something else? Differential Diagnosis

Respiratory System (J00-J99) Pneumonia (pneumonia) Blood, blood-forming organs – immune system (D50-D90). Chronic sarcoidosis (including cardiac sarcoidosis). Endocrine, nutritional, and metabolic diseases (E00-E90). Hyperthyroidism (hyperthyroidism). Cardiovascular system (I00-I99) Cardiac arrhythmias, unspecified Cardiomyopathy – group of cardiomyopathies leading to reduced cardiac function. Coronary artery disease (CAD) – coronary artery disease. Mitral valve prolapse – prolapse/protrusion of … Heart Muscle Inflammation (Myocarditis): Or something else? Differential Diagnosis

Heart Muscle Inflammation (Myocarditis): Complications

The following are the most important diseases or complications that can be caused by myocarditis (inflammation of the heart muscle): Cardiovascular disorders (I00-I99). Heart failure (cardiac insufficiency) [poor prognosis]. Cardiac arrhythmias, unspecified Cardiomyopathy (group of myocardial diseases that result in reduced heart function; dilated cardiomyopathy, DCM) [poor prognosis]. Pericarditis (inflammation of the pericardium). Sudden cardiac … Heart Muscle Inflammation (Myocarditis): Complications

Heart Muscle Inflammation (Myocarditis): Classification

In 1998, the Dallas criteria were established, allowing standardized diagnosis of myocarditis by endomyocardial biopsy (tissue samples taken from the inner surface of the heart muscle (myocardium)). First endomyocardial biopsy Active myocarditis Myocytolysis (disintegration of muscle cells) and myocyte necrosis (death of muscle cells) Lymphomonocytic infiltrate (pathologic: >5 lymphocytes/severe enlargement (400-fold)). Interstitial edema (fluid accumulation … Heart Muscle Inflammation (Myocarditis): Classification

Heart Muscle Inflammation (Myocarditis): Symptoms, Complaints, Signs

Myocarditis can present like a myocardial infarction (heart attack) with sudden onset of symptoms (angina pectoris (“chest tightness”; sudden onset of pain in the heart area) and arrhythmias) and/or heart failure (cardiac insufficiency) developing within days. In most cases, the symptoms (after an infection) are so uncharacteristic that only cardiac symptoms and/or dyspnea on exertion … Heart Muscle Inflammation (Myocarditis): Symptoms, Complaints, Signs

Heart Muscle Inflammation (Myocarditis): Causes

Pathogenesis (development of disease) In myocarditis, inflammation causes edema (swelling of tissue due to fluid retention) and secondary necrosis (cell death) of myocytes (muscle fiber cells). Structural dilatation can also be demonstrated. According to histology (microscopic examination of tissue), the following forms of myocarditis can be distinguished: Parenchymal myocarditis – the myocardium (heart muscle) is … Heart Muscle Inflammation (Myocarditis): Causes

Heart Muscle Inflammation (Myocarditis): Therapy

General measures Inpatient admission! Bed rest or sparing is required during myocarditis! After myocarditis is required for at least three months of sparing – during this time also no sports may be performed. Nicotine restriction (refrain from tobacco use). Alcohol restriction (abstaining from alcohol) Review of permanent medication due topossible effect on the existing disease. … Heart Muscle Inflammation (Myocarditis): Therapy