Some time ago, the hospital admitted a sports college student, the patient suddenly fainted during physical education class, unconscious, after the school doctor emergency chest cardiac compressions transferred to the hospital, after questioning that the patient had a week before the cold, when he thought he was young, usually good health, a cold does not matter, and did not rest well, still often play basketball, and finally led to viral myocarditis, and In the end, it led to viral myocarditis and cardiac arrest.
What is viral myocarditis?
Viral myocarditis is an infection of the heart with a cardiophilic virus that causes non-specific inflammation of the heart, resulting in chest tightness, palpitations, difficulty breathing, and even fainting, cardiac arrest, and sudden death. The symptoms of viral myocarditis are related to the extensiveness and location of the inflammatory lesions in the myocardium. In severe cases, it can lead to sudden death, while in mild cases, there are few symptoms. Some patients may have premature beats, especially after a cold or exertion, but most of them can improve on their own without special treatment. A variety of viruses can cause myocarditis, among which enteroviruses such as coxsackie, ECHO, poliovirus are the main viruses causing myocarditis; in addition, human adenovirus, influenza, parainfluenza, respiratory syncytial virus, etc. causing myocarditis is not uncommon. Therefore, when suffering from a cold, you should pay more attention to rest, replenish water and vitamins, protein, etc. to improve your resistance and avoid viruses from taking advantage of the situation and infecting your heart and causing myocarditis.
What is the age of onset of viral myocarditis?
Viral myocarditis can develop in people of all ages, but it is more likely to develop in young people, more in men than in women. Most patients have “flu” symptoms such as fever, general malaise, or intestinal symptoms such as nausea and diarrhea 1-3 weeks before the onset of the disease, followed by palpitations, chest tightness, chest pain, dyspnea, or in severe cases, dizziness and fainting, or cardiac arrest. Most patients clinically have palpitations, chest tightness, premature beats and other arrhythmias as the first symptoms. Very few patients develop rapidly after the onset of the disease and develop significant respiratory distress, heart failure or shock and syncope. Patients may feel a slower heartbeat or a significantly faster heartbeat on their own. Generally speaking, a one degree increase in body temperature is associated with a corresponding increase in heart rate of about 10 beats per minute in adults and about 15 beats per minute in children. In patients with myocarditis, the increase in heart rate is significantly higher than the increase in heart rate associated with an increase in body temperature. The electrocardiogram may show sinus tachycardia, atrioventricular block, premature ventricular beats, and ST-segment depression in several leads.
How should viral myocarditis be treated?
Once you have acute viral myocarditis, it is important for you to rest in bed for a period of time, eat foods rich in vitamins and proteins to strengthen your body’s resistance, and drink moderate amounts of water to promote the elimination of the virus. Clinically, one or more of these manifestations, including cardiac arrest, heart failure with or without myocardial infarction-like ECG changes, cardiogenic shock, acute renal failure, persistent ventricular tachycardia with hypotension or myocardial pericarditis, are called severe myocarditis and require active treatment. In addition to Western medical treatment in the acute phase, our traditional Chinese medicine has a unique role.
Clinically, there are relatively strict criteria for diagnosing viral myocarditis. Due to the diversity of the disease, there are some misconceptions about the diagnosis and treatment of viral myocarditis in daily life, which may exist even for some medical professionals. For example, in terms of diagnosis: for patients with a few premature beats within 3 weeks after signs of viral infection, or mild T-wave changes in the electrocardiogram, and mild elevation of other enzymes in the non-creatine kinase isoenzyme in the myocardial enzyme profile examination, it is not advisable to easily diagnose acute viral myocarditis; clinically, we also see some patients with respiratory distress after a cold within 3 weeks, and even pleural effusion is visible in chest radiography, but the index of myocardial damage is not elevated in the investigation. In fact, such patients may be symptoms caused by viral attack on lung tissue. In terms of treatment: some friends may think that the cold will naturally heal through vigorous exercise and sweating, not knowing that this may lead to the occurrence and aggravation of viral myocarditis; for some patients with mild myocarditis that manifests only as premature beats, medical personnel easily use strong anti-arrhythmic drugs, or for patients with viral myocarditis easily use hormone therapy and so on. These misconceptions may aggravate the disease or lead to other complications due to inappropriate treatment, which may adversely affect the patient.