Viral myocarditis is the inflammation of myocardium after viral invasion. It can occurs in any age, previously it is often seen in children but recently its occurence is increasing in ages.
The ECG (electrocardiogram) of this disease is non-specific. In blood analysis, ESR (erythrocytes sedimentation rate), ASAT (aspartate aminotransferase, previously known as GOT- glutamate oxaloacetate transaminase), CPK (creatine-phosphate-kinase) and LDH (lactate dehydrogenase) are increased. The increasing of CPK-MB is the most significant and its duration is long, therefore, this is the speficity of this disease. The analysis for the first week of this disease is finding of virus in throat swipe, fecal and blood; second and third week--is high level of specific antibodies in blood analysis. One can use the electron microscope to verify the existance of virus in tissue. Besides, the immunofluorescent assay can also confirm antibodies in myocardium, its sensitivity and speficity is higher than other methods.
The patients usually have history of viral infection about 1-2 weeks before this disease, signs include fever, dullness in chest, chest pain, heart palpitation, dypsnoe and decrease of myocardium function or arrhythmias. Dullness in chest is similar to angina pain, it can be relieved by nitroglycerin. While chest pain is similar to acute pericarditis, its pain is located anteriorly and irradiate to cervical region, the pain is intensed during movements or breathing. Those severe patients may have sudden cardiovascular shock or congestive heart failure and lead to death. During auscultation, one can hear persistent tachycardia, bradycardia or arrhythmia, pericardial friction sound, decreased of first tone, protodiastolic and presystolic gallop rhythm; all these are important diagnostic values.
Till now, this disease has no specific treatment method, it mainly uses symptomatic therapy. But during acute period, rest at bed is very important, the duration varies from few weeks to few months.
The modern medicine indicates that the pathological factor is still in study, generally many thought that virus invades the myocardium directly, human RNA viruses have high level of cardiopathy, it is affect the heart after infection and leads to pericarditis, myocarditis and endocarditis; then, the disease will progress to a slow stage due to own immune activation, causing pathological enlargement of the heart, arrhythmias and so on.
The traditional chinese medicine (TCM) indicates that this disease is caused by external virus which invades the heart, it will exhaust the Qi Yin ( yin energy) and then the virus will cause disease due to weak body; there is similar indication in xin ji (heart palpitation- literally means feeling of own acceleration heart beat especially when emotionally stimulated with signs of weakness, its symptoms are merely light), zheng chong (anxiety- literally means the feeling of heart palpitation with panic and intense when one is tired, it is a more severe form which transformed from xin ji ) and xu lao (general weakness-literally means decrease of immune function, imbalance of endocrine function, blood forming function impaired, regenerative function is disturbed, lack of nutrition, nervous function decreased or oversuppressed and caused illness with degenerative of other organs and system).
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