Carditis - inflammation of the lining of the heart of various localization and etiology. The disease can affect the epicardium, endocardium, myocardium, as well as the so-called pericardium - the pericardium. Currently, the general term "Card", as the disease can simultaneously hit several heart membranes.
Carditis: etiology and pathogenesis of the disease
The leading role in the development of carditis belongs to infectious agents (viral carditis provoked Coxsackie enterovirus, herpes simplex virus, ECHO, cytomegalovirus, rubella, poliomyelitis, adenovirus). Also causes of carditis are bacterial, parasitic, fungal infections, allergic reactions. There are carditis idiopathic nature when unidentified causes of the inflammatory process.
The pathogenesis of carditis is seen thus: pathogen enters directly into the tissue of the heart (endocarditis, myocardium, epicardium and pericardium - the pericardium), penetrating into myocytes (a special type of cell that forms the basis of muscle tissue), where it is replicated, namely, playing mostly pathogens by cell protein structures, which significantly disrupts the functioning of the host cell
. In response to the infection of the increased production of interferon in the body, which prevents further tissue damage heart
. Prolonged reaction to the introduction of the pathogen in the tissues of the heart is extremely rare
. In such cases, it is a latent, persistent infestation
. Typically, the agent is blocked and eliminated in a short time
. During the rehabilitation period in the affected tissues is observed active synthesis of collagen, which is sealed and transformed into fibrous tissue replaces the necrotic foci
Rheumatic carditis: classification, differentiation
Rheumatic carditis - inflammation of the lining of the heart caused by various factors, with the exception of rheumatic fever and other systemic diseases.
Rheumatic fever - systemic inflammatory process with the main focus of localization in the lining of the heart. Rheumatic heart disease - the main manifestation of rheumatic process in the body.
Non-rheumatic carditis diagnosed in patients of all age groups and gender. However, most carditis diagnosed at an early age. Boys are at greater risk for developing carditis.
In modern medical practice is to classify non-rheumatic carditis the period of occurrence, the type of agent, severity and nature of the flow, outcome.
In the period of occurrence of congenital and acquired distinguish carditis. Congenital carditis are the result of a virus or mother transferred bacterial infection. Early congenital carditis are the result of this illness by 4-7 weeks of pregnancy. Late congenital carditis develops as a result of infections in the third trimester of pregnancy. Acquired carditis a child are extremely rare and are a consequence of undergoing an acute infection (sepsis, influenza, pneumonia).
By type of course carditis distinguished:
- The sharp - duration of the inflammatory process up to 3 months;
- Subacute - carditis duration of up to 18 months;
- Chronic - lasting more than 18 months.
In the diagnosis of carditis in children must be differentiated with mitral stenosis, congenital heart disease, neoplastic processes in the heart, rheumatism, arrhythmias extracardiac origin.
Carditis children: Risks and complications
Exodus carditis in children depends on many factors, among which are genetic predisposition, overall health, the child's age at onset, immune status, timeliness and effectiveness of selected therapies.
Possible outcomes carditis are:
- Full recovery, which can be seen after 12-18 months from the onset of the disease. In chronic and subacute carditis full recovery usually does not occur;
- Arrhythmia - a complication of carditis in children characterized by persistent cardiac arrhythmias. Often, this complication is the cause of death of children in chronic carditis;
- Cardiosclerosis and myocardial hypertrophy - when such complications carditis in children characterized by a severe, often fatal;
- Pulmonary hypertension - a change of pulmonary artery vascular pool persistent nature that worsens the prognosis of the disease.
Carditis: symptoms of various types
If carditis symptoms will depend on the etiology of the disease, the time of its appearance and shape.
When purchasing acute and subacute symptoms of carditis initially may have noncardiac character (not caused by dysfunction of the heart), which include:
- Decreased appetite;
- Lethargy, fatigue, irritability;
- nausea, vomiting.
Symptomatic complex carditis may be supplemented by signs of an infection caused by the disease: skin redness and rash, orchitis, myalgia. In the course of carditis pathology, symptoms complemented signs of heart failure (shortness of breath, tachycardia, arrhythmia). Children at an early age appears anxiety, cough. Pain in the heart, of which the child is still unable to report, is determined by the child's reaction to the movements of his body (the child reflexively avoid sudden movements, crying during movement), as well as shallow breathing (the movement of the chest during inspiration causes painful sensations that provokes child significantly limit the depth of inhalation). In chronic carditis symptoms may not appear for a long time. The clinical picture is complemented by a suffocating cough, amplified in the supine position, cyanosis purple cheeks, the lips, palms and nails.
Carditis: the treatment of the disease
If carditis treatment requires an integrated approach. His tactics will depend on the causes of carditis, duration of the disease, the nature of the flow carditis. In acute carditis treatment should be carried out in a hospital. When remissions carditis treatment on an outpatient basis. The main medication drugs used in the treatment of carditis are cardiac glycosides, diuretics, hormones. In acute carditis patients displayed during strict bed rest, restriction of fluids you drink (it should be less than the amount of urine output), a complete diet with restriction of salt and increase the share of products containing potassium (potatoes, raisins, dried apricots).
Often used physiotherapy, during periods of remission, on the contrary, exercise contraindicated (recommended exemption from physical education in school an extra day).
After suffering carditis preventive vaccination is contraindicated in the first 3 - 5 years. With early diagnosis and proper treatment tactics carditis forecast favorable.