Summary:
In the submitted paper the author summarizes findings concerning the controversial disease of
contemporary cardiology - myocarditis. The prevalence of myocarditis in post-mortem material is
about 1%. It is usually of viral origin (in particular Coxsackie viruses group B). The origin can be
however also bacterial, spirochetal, mycoplasmatic, mycotic, protozoan and helminthic. Clinically
it is manifested by a wide spectrum of manifestations from subclinical forms to fatal conditions
(cardiac failure to cardiogenic shock, arrhythmia).
On the ECG it is usually manifested by changes of the repolariization stage ST-T, by impaired
conduction, possibly by pathological Q waves. Echocardiography can reveal localized (rarely
diffuse) kinetic disorders which frequently do not correspond to classical areas supplied by
a certain coronary atery,reversible myocardial hypertrophy is frequent. As to biochemical mar-
kers, sometimes a prolonged elevation of cardiospecific enzymes can be recorded. The most accu-
rate evidence is that obtained by endomyocardial biopsy (but low activity).
As to treatment, we start in the acute stage with bed rest and antibiotics, administration of
angiotensin converting enzyme inhibitors is also recommended. In exceptional cases (in particu-
lar progressing acute conditions) administration of corticosteroids and/or immunosuppressives
can be tried. Non-steroid anti-rheumatic preparations are not administered with the exception of
symptomatic indication, (except in the acute stage of the disease).
Key words:
Myocarditis - Etiology of myocarditis - Diagnosis of Myocarditis - Therapy of myocar-
|