Mlejnek Dalibor, Krejčí Jan
Vnitr Lek. 2017 Fall;63(7-8):507-512.
Myocarditis is an inflammation of the heart muscle. The most common cause of myocarditis is viral infection in industrialized countries. Myocarditis with left ventricular dysfunction is called inflammatory cardiomyopathy and is the major cause of dilated cardiomyopathy. The clinical picture is very diverse, most often the patient present with signs of heart failure, arrhythmic symptoms and chest pains. Despite significant advances in non-invasive diagnostics, particularly magnetic resonance imaging, endomyocardial biopsy remains the gold standard of myocarditis diagnosis. Myocarditis and inflammatory cardiomyopathy therapy is primarily based on the restriction of physical activity and the pharmacotherapy of heart failure. Specific treatment - immunosuppressive or antimicrobial - may be considered in some cases according to endomyocardial biopsy results. Implantation of mechanical cardiac support or heart transplantation is indicated only in the most serious cases.Key words: clinical course - diagnostics - inflammatory cardiomyopathy - myocarditis - treatment.
心肌炎是心肌的炎症。在工业化国家，心肌炎最常见的病因是病毒感染。伴有左心室功能障碍的心肌炎被称为炎症性心肌病，是扩张型心肌病的主要病因。临床表现非常多样，患者最常出现心力衰竭、心律失常症状和胸痛等体征。尽管无创诊断技术取得了重大进展，尤其是磁共振成像，但心内膜心肌活检仍是心肌炎诊断的金标准。心肌炎和炎症性心肌病的治疗主要基于限制体力活动以及心力衰竭的药物治疗。根据心内膜心肌活检结果，在某些情况下可考虑进行特异性治疗——免疫抑制或抗菌治疗。仅在最严重的病例中才考虑植入机械心脏支持装置或进行心脏移植。关键词：临床病程 - 诊断 - 炎症性心肌病 - 心肌炎 - 治疗
