Maisch Bernhard, Richter Anette, Koelsch Susanne, Alter Peter, Funck Reinhard, Pankuweit Sabine
Department of Internal Medicine - Cardiology, UKGM GmbH and Philipps University Marburg, Baldingerstrasse, 35043, Marburg, Germany.
Herz. 2006 Dec;31(9):881-90. doi: 10.1007/s00059-006-2941-4.
Inflammatory cardiomyopathy and myocarditis are considered acquired forms of dilated cardiomyopathy. Whereas consensus documents on the diagnosis of myocarditis and perimyocarditis do exist, guidelines on the specific treatment have been established only for the management of pericardial diseases, which at least partly can be applied in analogy to myocarditis. Presently, feasible clinical pathways are available, which can lead to a correct diagnosis and specific treatment. This is illustrated with two cases of fulminant myocarditis, in one with successful diagnosis and treatment of a cardiac sarcoid and another one in which diagnostic nihilism led to a lethal outcome in giant cell myocarditis at necropsy. A case of active parvo B19-positive myocarditis demonstrates the role of immunoglobulin treatment under these conditions.
炎症性心肌病和心肌炎被认为是扩张型心肌病的后天形式。虽然确实存在关于心肌炎和心包心肌炎诊断的共识文件，但仅针对心包疾病的管理制定了具体治疗指南，这些指南至少部分可类推应用于心肌炎。目前，有可行的临床路径，可导致正确诊断和特异性治疗。这通过两例暴发性心肌炎病例来说明，一例成功诊断并治疗了心脏结节病，另一例诊断虚无主义导致巨细胞心肌炎尸检时出现致命结果。一例活动性细小病毒B19阳性心肌炎病例展示了在这些情况下免疫球蛋白治疗的作用。
