Case: In 2008, an Olympic volunteer, with chest tightness and panic as the main symptoms cited, was suspected of myocarditis after examination, and after the symptoms were relieved by treatment the patient asked to leave the hospital, but considering the potential risk of myocarditis, our doctors kept him, as a result, the patient later died suddenly, and due to timely treatment, the patient was successfully rescued and has now basically recovered. It is hard to imagine the consequences if he had been released at that time and this had happened in the street. So, how exactly is myocarditis a disease?
How is myocarditis caused?
Myocarditis is a limited or diffuse inflammation of the heart muscle. The causes of acute myocarditis can be broadly classified into three categories.
① myocarditis caused by infection of the myocardium with pathogenic microorganisms such as bacteria and viruses.
② myocarditis due to allergic or metabolic reactions.
(iii) Myocardial damage caused by chemical, physical, and drug toxicity.
Among them, the myocardium is most often induced by viral infections, with more obvious triggers such as influenza virus and enterovirus infections. When a virus infects the myocardium, the virus can either cause direct damage to the myocardium or cause myocardial cell damage through an autoimmune response.
What are the clinical manifestations of myocarditis?
The clinical manifestations of myocarditis vary widely. In mild cases, there may be no symptoms or discomfort such as palpitations, chest tightness, vague pain in the precordial region, and weakness; in severe cases, the disease is aggressive and can include arrhythmias, heart failure or cardiogenic shock, and even sudden death. Anyone who has a cold or diarrhea, and within a short period of time (usually 1-2 weeks after the disease) has heartburn, chest pain, chest tightness, shortness of breath, fatigue, pallor, sweating, dizziness, precordial discomfort or convulsions, should be alert to the possibility of myocarditis and should not take it lightly, and should seek early medical attention.
What should I do if I have myocarditis?
Once viral myocarditis is diagnosed, the patient should rest adequately during the acute phase, at least 3 months after the heart function is restored to normal in mild cases, and 6 months to 1 year in severe cases. The treatment can be antiviral drugs, such as with amantadine, cytarabine and interferon; choose vitamin
C, inosine, adenosine triphosphate, coenzyme A, cytochrome C, etc., to promote the metabolism of cardiomyocytes and help repair the damaged myocardium. In addition, the use of Chinese herbal medicine to identify and treat the symptoms of myocarditis, the appropriate application of Pan Lan Gen, Lian Qiao, Guan Zong, Tiger Balm and other drugs to clear the heat and detoxification of viral myocarditis has a very good effect.
Can myocarditis be cured and is it hereditary?
Myocarditis is not hereditary. It is a self-limiting disease and most of them have a good outcome. It is a self-limiting disease and the majority of patients have a good outcome with rest, treatment and regular follow-up by the doctor. Only a very small number of patients develop chronic myocarditis or dilated cardiomyopathy.
Myocarditis should be taken seriously but not “amplified”
Myocarditis should be taken seriously but not “amplified. In recent years, you may find that more and more children are suffering from toxic myocarditis, which on the one hand is related to the more toxic upper respiratory infections in children in China, and on the other hand is also due to the overly broad diagnosis of myocarditis, some units will be young people with premature beats, chest tightness, chest pain and other symptoms are classified as myocarditis; there is no information on the examination of viruses, that is, crowned with a viral cause. As a result, the number of “myocarditis patients” has increased significantly, resulting in many unnecessary hospitalizations, examinations, treatments, suspensions and absences from school, which, in addition to the incalculable economic losses, have caused unnecessary panic in many families. Because of this, our country has revised the diagnostic criteria for myocarditis to be more stringent than before, which helps to prevent ‘amplification’ and thus prevents parents and children from carrying a heavy psychological burden.
Do I have to take a break from school if I have myocarditis?
Generally viral myocarditis is treated in the hospital for about 3 weeks, and then it can be treated at home. Because of the specific nature of the virus damage to the heart, the recovery period is longer than the virus damage to other organs, usually 3 months to 6 months. During this time some patients with myocarditis will insist on going to school because they do not want to delay their classes, but they should be careful not to overexert themselves, limit their physical activity appropriately, and have regular follow-ups at the hospital.
Can myocarditis also cause sudden death?
It is not alarming that myocarditis can also cause sudden death, especially after strenuous exercise. The case given at the beginning of this article deserves your attention. Since teenagers like to participate in sports activities, they often do not pay attention to minor symptoms and their condition deteriorates rapidly during the activity. Therefore, it is important to remind our teenagers that once they have symptoms, they should take rest, stop participating in strenuous sports and go to the hospital for further examination. After regular treatment, the majority of patients can be completely cured without any sequelae and can continue to participate in strenuous sports or competitions.
Why is it that some people do not get well easily with myocarditis?
1, treatment is not timely enough: light myocarditis early, the clinical symptoms are more light, only the electrocardiogram has abnormal changes, X-ray and echocardiography results abnormal rare, not easily detected by parents, clinicians may also ignore and miss the diagnosis, failure to timely rest treatment, resulting in delay, aggravation, and even has developed into chronic. The best time for treatment is lost.
2, do not pay attention to rest: not adhere to the treatment of myocarditis clinical manifestations are often lighter than the actual disease, so that some parents do not pay attention to, after hospitalization treatment improved discharge or after a period of outpatient treatment, no longer continue to use drugs, participate in all sports activities, so that the condition is delayed or aggravated.
3, repeated infections: after suffering from myocarditis some children have reduced immune function, especially cellular immune function, susceptible to bacterial or viral infections, which can lead to aggravation and recurrence of myocarditis, so in the course of myocarditis, attention should be paid to strengthening the immunity of the body, such as a cold or other infections, to take active treatment measures.
4, did not adhere to long-term follow-up: regular outpatient follow-up can have systematic observation of the condition, get the doctor’s guidance, if there are changes in the condition, timely adjustment of the treatment plan. Make the condition recover smoothly.
5, related to the severity of the disease: light and medium-sized cases, after regular rest and treatment, most of them can be completely recovered; heavy cases because of its extensive, serious lesions, the onset of the more urgent, even if actively rescued, regular treatment, the disease is easy to delay or sequelae, or even death.
How to prevent myocarditis?
To prevent viral myocarditis, you should first prevent colds and intestinal disinfection infections, often participate in physical exercise to improve their own resistance to disease, residential windows are often opened and ventilated to keep the air fresh; during the flu season, try to go to public places as little as possible to prevent various viral infections. Regular influenza vaccination to obtain immunity against influenza can effectively prevent viral colds in the spring and autumn seasons when the climate is changeable. Vaccination is generally recommended in early autumn and can effectively prevent influenza for 12 months. Once a viral infection occurs, it is important to take rest and avoid overexertion, and never smoke or drink alcohol. In addition, pay attention to nutrition, correct the bad habits of partial diet, daily diet with coarse grains, fresh vegetables and lean meat, but also appropriate to eat more fruit.
What should I do if I have the sequelae of myocarditis?
The majority of patients can be cured after timely and effective treatment during the acute phase of myocarditis. However, a very small number of children will develop myocarditis sequelae, which seriously affects life, work and study, when the effect of pure Western medicine treatment is not good, but with Chinese medicine evidence-based treatment, can often achieve very good results. A girl with myocarditis from Yantai, Shandong Province, had panic attacks, weakness, and a heart rate of about 100 beats at rest, which accelerated even more after activity, and was so distressed that she had no choice but to take a break from school. According to the patient’s characteristics of positive deficiency and evil love, we adopted the method of benefiting Qi and nourishing Yin, clearing heat and toxicity, nourishing the heart and calming the mind, with additional reduction and treatment for more than a month, the symptoms were significantly reduced and she has resumed normal schooling.