The child is 7 months old and has viral myocarditis. Please help me. Urgent!

Myocarditis refers to local or diffuse acute, subacute or chronic inflammatory diseases of myocardium. In recent years, the relative incidence of viral myocarditis has been increasing. The severity of the disease varies greatly. Babies are heavier, adults are lighter, and those who are lighter may have no obvious symptoms. Severe cases may be complicated with severe arrhythmia, cardiac insufficiency or even sudden death.

Precursor symptoms of acute or subacute myocarditis, patients may have fever, fatigue, sweating, palpitation, shortness of breath, precordial pain and so on. The examination showed arrhythmia such as premature beat and conduction block. Aspartate aminotransferase and creatine phosphokinase increased, and erythrocyte sedimentation rate increased. Electrocardiogram and X-ray examination are helpful for diagnosis. Treatment includes rest, improving myocardial nutrition, controlling cardiac insufficiency, correcting arrhythmia and preventing secondary infection.

viral myocarditis

The cause of disease

Myocarditis is a localized or diffuse inflammation of myocardium, which can be primary in myocardium or a part of systemic diseases. The reasons are infection, physical and chemical factors, drugs and so on. Viral myocarditis is the most common, among which enterovirus, especially Coxsackie B virus infection is the most common.

clinical picture

1. Symptoms: fatigue, fever, chest tightness, palpitation, shortness of breath, dizziness. In severe cases, cardiac insufficiency or cardiogenic shock may occur.

2. Signs: the heart rate increases rapidly, which is not proportional to the increase of body temperature, the heart boundary expands, the murmur changes, and arrhythmia.

take medicine

1, treatment of primary disease: very critical. People infected with the virus can take the antiviral drug amantadine 200 mg; One day; Maringuanidine 0. 1g, taken orally, three times a day. If there is bacterial infection, antibiotics can be given.

2. Symptomatic treatment: stay in bed at the acute stage. After the symptoms and signs improve and the electrocardiogram is normal, you can gradually increase the activity and give a nutritious and digestible diet. Cardiac insufficiency, arrhythmia and shock should be corrected actively.

3. Promote myocardial metabolism

(1) Vitamin C: 4 ~ 5g is added into 250ml solution for intravenous drip, once a day, 1 0 ~ 1 5 days is1course of treatment, which can be repeated.

(2) Energy mixture: ATP 20mg ++ coa 100 u+ cytochrome C30mg plus 5% glucose 500ml intravenous drip, once a day, 1 0 to 15 days is 1 course of treatment, which can be repeated.

(3) Inosine: 200 ~ 400 mg orally or intramuscularly, twice a day.

(4) Cyclic adenosine monophosphate (camp): 20 ~ 40 mg, intramuscular injection, twice a day.

(5) Polarizing solution: 500ml of 10% glucose and 8u of common insulin, and 15% potassium chloride 10ml intravenous drip, with 7 ~ 10 days as 1 course of treatment.

(6) Immunosuppressants: used for chronic and persistent cases. Glucocorticoid: It is generally not recommended to use it within 10 ~ 14 days after onset, but it can be used for patients with high fever, heart failure, severe arrhythmia and cardiogenic shock. Prednisone 40 ~ 60 mg, daily 1 time, or hydrocortisone 400 ~ 600 mg, daily 1 time, can be given intravenously, and the amount will gradually decrease after the condition improves, about 26%.

prevent

Strengthen physical exercise, improve the body's disease resistance, avoid fatigue and prevent virus and bacterial infection. Pay attention to rest and nutrition after the onset, so as to facilitate the recovery of the heart.

Prevention of spring myocarditis: In recent years, due to the wide application of antibiotics, rheumatic fever caused by streptococcus infection has gradually decreased, and the incidence of rheumatic myocarditis has decreased significantly, while the incidence of viral myocarditis has increased day by day. Viral myocarditis can be caused by a variety of virus infections, among which Coxsackie virus B is the most common, and chickenpox and EB virus can also be caused. According to research, about 5% of virus-infected people can involve the heart and cause myocarditis. It can be caused by direct invasion of myocardium after virus infection, or by autoimmune reaction after virus infection. The former is more common in children, while the latter is more common in teenagers. Moreover, spring is the high incidence season of viral myocarditis, which should arouse people's vigilance.

Symptoms of upper respiratory tract infection or intestinal infection appear at the beginning of the disease, and chest tightness, palpitation, extreme fatigue, hyperhidrosis and other symptoms appear after 7- 10 days. At this time, if you do ECG, you may find myocardial damage such as arrhythmia and premature beats. Erythrocyte sedimentation rate (ESR) and myocardial enzymes may increase. After 2-4 weeks, coxsackie virus antibody and anti-myocardial antibody can be positive.

Viral myocarditis varies in severity, so the symptoms vary widely. Patients with mild localized lesions may have no symptoms, no abnormal ECG manifestations, and no increase in erythrocyte sedimentation rate and myocardial enzymes. Some people discovered that they had myocarditis at autopsy because of an accident. In severe cases, there are obvious symptoms, such as diffuse enlargement of the heart and heart failure, which leads to obvious shortness of breath and inability to lie down; Some severe arrhythmia, leading to repeated syncope, and even sudden death.

Studies have shown that viral myocarditis is easy to occur if you continue to be nervous, overworked, engaged in heavy physical labor and strenuous exercise after virus infection. In addition, malnutrition is also an inducement. After the occurrence of viral myocarditis, you must stay in bed absolutely, otherwise it will aggravate the condition and cause serious complications.

After suffering from viral myocarditis, you usually have to rest for 3 months. If there are no symptoms in the future, you can gradually resume your work and normal study, but you should still be careful not to be too tired. 1 year can't engage in manual labor and sports. In addition, we should pay attention to a reasonable diet and eat more fresh fruits and vegetables to ensure a balanced nutrition. Ensure adequate sleep and rest to avoid catching a cold, otherwise it is easy to relapse. Repeated attacks can turn into chronic myocarditis and cardiomyopathy, which is harmful for life.

Dietotherapy for myocarditis-it has special effects on treating myocarditis.

Patients with myocarditis don't have too many taboos in diet, but they should gradually heat up according to their physical condition. Warm-up refers to foods with warm eating habits, such as beef, mutton, eel, sweets, red dates, longan, lychee, onion and ginger. Women who are sick and afraid of the cold often eat this kind of food, which helps to get angry, improve the feeling of being afraid of the cold, and thus enhance their physique. People with myocarditis and coronary heart disease should take some ginseng powder. ginseng powder can soothe the nerves, strengthen the heart, lower blood pressure and dredge the pulse. Here are some dietary treatments:

1. Deng Xin bamboo leaf tea

9 grams of Juncus Juncus and 6 grams of bamboo leaves were decocted and filtered with water instead of tea. Or boiled water, not tea. 1 dose/day. Function: clearing away heart fire, benefiting damp-heat, removing annoyance and calming the nerves. Indications: Acute stage of damp-heat viral myocarditis.

2. Ruby tea

3g of Ginseng Radix Rubri, 4.5g of Cinnamomum cassia, 0g of Polygonatum odoratum, hawthorn12g, 0g of Polygonatum sibiricum10g, 0g of fried jujube kernel15g, 6g of roasted licorice, soaking in water, boiling in a casserole, and pouring into a tea drinking container; Or put the medicine into a tea container and brew it with boiling water instead of tea. Functions: supporting yang to save adverse events, benefiting qi and nourishing yin, promoting blood circulation and calming the nerves. Indications: Chronic viral myocarditis caused by deficiency of both yin and yang and blood stasis blocking collaterals.

3. Danshen Zhuxin Decoction

Codonopsis pilosula 1 5g, Salvia miltiorrhiza 1 0g, Astragalus membranaceus10g, wrapped in gauze, stewed in water with1pig heart, and taken in broth, once a day, which can be used for the treatment of cardiomyopathy, and can also be used as an adjuvant for various heart diseases and cardiac insufficiency.

4. Bamboo shoots

Bamboo shoots 120g, shredded, sliced lean meat 1g, fried with peanut oil and eaten.

5. Chrysanthemum carp soup

1 carp, cut open, wash, stir-fry, add 25g of white chrysanthemum, 5g of medlar15g of water, stew until cooked, and then eat meat and drink soup in batches.

6. Suanzao Shrimp Shell Soup

Take 25g of shrimp shell, Ziziphus jujuba seed 15g, polygala tenuifolia 15g, and take * * * soup, daily 1 dose, which can cure myocarditis.

Health medicated diet for myocarditis

1. Tremella Prince Soup

Tremella fuciformis 15g, Pseudostellaria heterophylla 25g, and appropriate amount of rock sugar. Drink after decocting in water. Nourish the body.

2. Zhu Xin Zao Tang

1 broken pig heart with blood, jujube 15g in a bowl, steamed with water. Nourishing blood, nourishing the heart and calming the nerves. It is suitable for palpitation, fatigue, listlessness, gloomy complexion and various heart diseases caused by insufficient heart blood.

3. Danshen Zhuxin Decoction

Codonopsis pilosula 15g, salvia miltiorrhiza 10g, astragalus membranaceus 10g, cinnabar, wrapped in gauze, stewed with water with 1 pig heart, and taken with meat soup once a day, which can be used for treating cardiomyopathy, various heart diseases and cardiac insufficiency.

4. Bamboo shoots

Bamboo shoots 120g, shredded, sliced lean meat 1g, fried with peanut oil and eaten.

5. Chrysanthemum carp soup

1 carp, cut open, wash, stir-fry, add 25g of white chrysanthemum, 5g of medlar15g of water, stew until cooked, and then eat meat and drink soup in batches.

6. Suanzao Shrimp Shell Soup

Take 25g of shrimp shell, Ziziphus jujuba seed 15g, polygala tenuifolia 15g, and take * * * soup, daily 1 dose, which can cure myocarditis.

7.bitter tea

Composition: Radix Sophorae Flavescentis, Rhizoma Coptidis, plumula Nelumbinis and Glycyrrhrizae Radix each 6g, Folium Bambusae and Folium Perillae each 3g, soaked in water, boiled in casserole, and poured into a tea drinking container; Or put the medicine into a tea container and brew it with boiling water instead of tea.

Function: clearing away damp-heat, detoxifying, aromatizing and calming the nerves.

Indications: Acute phase of heart-type viral myocarditis caused by damp-heat; Symptoms include diarrhea, abdominal pain, fever, limb pain, burning anus, red tongue, yellow greasy tongue coating, slippery pulse or knot formation.

8.jinyu tea

Composition: Flos Lonicerae, Radix Isatidis and Radix Astragali each 65438 05g, Rhizoma Polygonati Odorati and Fructus Crataegi each 65438 00g, and Radix Glycyrrhizae 6g, soaked in water, boiled in casserole, and poured into a tea drinking container; Or put the medicine into a tea container and brew it with boiling water instead of tea.

Function: remove residual pathogens, invigorate qi and nourish yin.

Indications: viral myocarditis with pathogenic heat at the end of the day and deficiency of both qi and yin can not be cured; Symptoms are still low fever, sore throat, shortness of breath, chest tightness, fatigue, palpitation, spontaneous sweating and night sweats, or chest pain, dry mouth, insomnia, red tongue tip, thin yellow or less fur, and rapid pulse.

9.honeysuckle porridge

Composition: 30g of honeysuckle is washed, soaked in water, decocted twice, dregs are removed, juice is taken, 50g of japonica rice is added, and porridge is cooked. Take 1 dose twice a day.

Function: clearing away heat and toxic materials.

Indications: Acute stage of wind-heat type viral myocarditis.

10. Lentils and barley porridge

Composition: 20 grams of lentils, 30 grams of coix seed, 50 grams of rice, and appropriate amount of water, first boiled into porridge, seasoned with oil and salt.

Indications: Heart-type viral myocarditis caused by dampness toxin.

1 1. Yang Shendan feather tea

Composition: 3g of American ginseng, 0g of Polygonatum odoratum10g, 0g of Salvia miltiorrhiza15g, 6g of hawthorn, 6g of roasted licorice, soaked in water, boiled in a casserole, and poured into a tea drinking container; Or put the medicine into a tea container and brew it with boiling water instead of tea.

Function: benefiting qi and nourishing yin, promoting blood circulation and calming the heart.

Indications: Recovery period of viral myocarditis with deficiency of both qi and yin and blood stasis blocking collaterals.

Seven taboos for patients with myocarditis

First, avoid losing weight sharply.

Lightning starvation diet will lead to rapid weight loss, a large number of protein consumption and muscle tissue reduction, which will lead to myocardial tissue decline and induce heart failure.

Second, avoid feeling full.

Overeating three meals and expanding the stomach wall will increase lung pressure, lead to increased cardiac metabolism and easily induce an induced myocardial infarction.

Third, avoid frequent overnight stays.

It is dangerous for myocarditis patients to get up in the middle of the night.

Fourth, avoid rejecting fat.

If myocarditis patients eat fish fat twice a week, their mortality rate is 30% lower than that of patients who limit all fat and only eat high-fiber food. Therefore, it is helpful for heart patients to arrange fish and poultry food properly in three meals a day.

Five, avoid rapeseed oil

Rapeseed oil contains 40% erucic acid. Patients with myocarditis will thicken the blood vessel wall and accumulate heart fat after eating it, which will aggravate the condition.

Sixth, avoid running in the morning.

Japanese sports medicine experts have found that jogging in the morning will put undue pressure on the heart, so we should take a walk and practice breathing.

Seven, avoid drinking.

Including alcoholic beverages, may cause myocardial infarction.

How to prevent myocarditis

Viral myocarditis is primary myocardial inflammation caused by cardiotropic virus, which often involves pericardium and causes pericardial myocarditis. Therefore, it is of great significance to prevent infection and actively treat infectious diseases, especially to avoid colds and treat upper respiratory tract infections, chronic pharyngitis and tonsillitis, which can prevent myocarditis. In addition, chemicals such as alcohol can directly lead to myocarditis, so don't drink too much. Patients with myocarditis must give up drinking. Because of the existence of "autoimmune reaction" in myocarditis, simple immune level is not the standard of disease prevention. Blind injection of immune biological agents (vaccine, immune protein, interferon, interleukin, etc.). ) not only can't prevent myocarditis, but it will even aggravate the condition, which will do more harm than good.

We should have a full understanding of the long-term treatment of myocarditis. Because of the particularity of heart damage, its recovery period is much longer than the damage period, generally about half a year, or even one to two years, and it is easy to relapse and aggravate, so we must adhere to long-term treatment and correctly carry out life care. Suffering from myocarditis, the vast majority of patients can be cured as long as they are treated correctly in time. Patients should stay in bed as much as possible and eat digestible food; Due to the long treatment cycle, some patients do not want to delay their work and study, but they should also pay attention to limiting physical activity, not being tired and having regular examinations. Once, a Shanghai patient was diagnosed with viral myocarditis, which caused severe arrhythmia due to cold and fatigue. He was rescued twice in three months' treatment. After entering the university, the disease recurred and was not effectively controlled. After treatment with Yu Dan Rong Xin Pill, the condition quickly stabilized and ventricular premature beats disappeared. The patient was very happy. He thought it was cured and planned to stop taking the medicine. After detailed analysis, the doctor thinks that his condition is in a chronic stage and the objective data is still unstable. We must insist on treatment. The patient's short-term withdrawal of drugs did cause the fluctuation of his condition, which once affected his study and life. Under the supervision of the doctor, the patient continued uninterrupted treatment, his condition was controlled, and he successfully completed his college studies without recurrence.

The prognosis of most myocarditis is good, as long as it is treated properly, it will not leave any sequelae.

How to treat myocarditis

At present, there is no specific treatment for myocarditis in clinic, and early comprehensive treatment must be emphasized. Once the patient is diagnosed with myocarditis, the following treatment measures should be taken immediately to avoid delaying the illness and missing the favorable opportunity for treatment.

1. General therapy

Includes the following aspects:

(1) Early and reasonable bed rest is extremely important, which can repair the myocardium with inflammatory lesions as soon as possible and prevent the disease from getting worse. Generally, patients with myocarditis need to stay in bed for 3-4 weeks after hypothermia, and those with heart failure or heart enlargement need to rest for 0.5- 1 year, or after the heart size returns to normal and the ESR is normal.

(2) Prevention and treatment of myocarditis The most common cause is upper respiratory tract infection, so it is necessary to prevent colds and viruses from invading the body. Because virus infection often coexists with bacterial infection or occurs one after another, and bacterial infection can often make the virus active, reduce the body's resistance and aggravate heart damage, so it is necessary to control bacterial infection in time through appropriate application of antibiotics. For some susceptible patients, such as recurrent tonsillitis, tonsillectomy can be performed when necessary to remove the inducement and/or inject transfer factor and gamma globulin to enhance the body's resistance and prevent recurrence.

(3) Promoting myocardial repair Patients with myocarditis can inhale human oxygen and apply some drugs to improve myocardial metabolism, so as to promote myocardial repair, prevent the further development of the disease and reduce the occurrence of complications. Such drugs commonly used in clinic are:

① High-dose vitamin C. Patients with myocarditis can take 200 ~ 500mg of vitamin C orally three times a day, and they can also take 5 ~ 10g intravenously in batches. 10 ~ 14 days is a course of treatment. Vitamin C has antiviral effect, which can increase coronary blood flow, promote myocardial metabolism, increase myocardial utilization of glucose, and is beneficial to myocardial repair.

② Energy polarized liquid. The components of energy polarization liquid include adenosine triphosphate (ATP), coenzyme A, potassium chloride, insulin, glucose, etc., which can provide energy for myocardium and promote myocardial metabolism, thus accelerating the repair process. Generally, 10 ~ 14 days is a course of treatment, and intravenous drip can be repeated.

③ Coenzyme Q 10, inosine, etc. The role of these drugs is to improve myocardial metabolism, which is very beneficial to myocardial repair. Clinically, it is often given orally to patients with myocarditis to cooperate with treatment.

2. Etiology therapy

Etiological treatment is the cause of myocarditis. Patients with viral myocarditis can take some antiviral drugs orally, such as Virulin, Radix Isatidis, Flos Lonicerae, Fructus Forsythiae, etc. Patients with rheumatic myocarditis are treated with anti-rheumatic therapy during the active period of rheumatism, such as intravenous drip of antibiotics; Patients with syphilis myocarditis need to take a series of measures such as expelling plum at the same time to eliminate or control the causes of myocardial damage and prevent the further development of the disease.

3. Hormone therapy

The purpose of hormone application is to reduce the inflammatory reaction of myocardium, reduce the formation of myocardial scar and improve the general condition of patients and myocardial microcirculation. Proper use of hormones can control the development of diseases and improve the symptoms of patients. For patients with critical or recurrent myocarditis and patients with obvious viremia or ineffective general treatment, early, sufficient and short-term application of adrenocortical hormone can obviously alleviate the condition. However, hormones should be avoided in the first 10 days in acute viral infection to avoid the spread of the virus and aggravate the disease.

4. Treatment of complications

Complications of myocarditis include heart failure, arrhythmia and even shock, which should be dealt with in time. If heart failure occurs, cardiotonic diuretics can be given; Arrhythmia should be treated according to specific conditions. Patients with ventricular premature beats can be given slow rhythm, and those with severe atrioventricular block can be given isoproterenol. Once patients with myocarditis go into shock, their condition is very critical. We must seize the opportunity to rescue them, and take measures such as expanding capacity and strengthening drugs to save lives.

Treatment measures of myocarditis in children

Comprehensive measures should be taken to treat myocarditis in children, including:

1, get enough rest, usually 1 ~ 3 months is appropriate;

2, reasonable diet, reasonable aftercare to reduce the burden on the heart;

3. Actively carry out anti-infection treatment to improve myocardial metabolism. High-dose intravenous injection or intravenous drip of vitamin C has obvious effect, and Chinese medicine treatment measures can also achieve good results. Traditional Chinese medicine treatment mainly nourishes myocardium and improves cardiac function.

The treatment of myocarditis in children should be timely, otherwise it will become more and more serious and even lead to damage to other organs. In addition, child care is also very important. In terms of diet, you can eat more fruits and vegetables such as tomatoes and jujubes to avoid overeating to reduce the burden on your heart. Physical exercise should follow the principle of gradual progress after illness, starting from a small amount to avoid excessive fatigue.

What is the prognosis of patients with myocarditis?

The prognosis of patients with myocarditis depends on the type of myocarditis, the location, scope and degree of myocardial damage, as well as the original cardiac function, whether there are complications, timely treatment and other factors. Generally speaking, the vast majority of patients with viral myocarditis have a good prognosis, and most of them fully recover within a few weeks to several months and can be cured. Only a few patients left the so-called "sequela", which showed abnormal electrocardiogram, most of them were premature beats, and some patients could develop dilated cardiomyopathy and even lead to sudden death. Patients with rheumatic myocarditis are more prone to heart failure and even acute pulmonary edema than patients with viral myocarditis. Patients with idiopathic myocarditis have a poor prognosis and can die of progressive heart failure within a few weeks. The damaged area of myocardium is limited; The prognosis of patients with small range and light degree is good, and vice versa. In addition, whether to rest and treat in time also has a great influence on the prognosis of patients with myocarditis. If patients can't get early rest and treatment, on the one hand, the condition of myocarditis will further deteriorate, on the other hand, it will also lead to various complications, which will bring difficulties to future treatment and is not conducive to the recovery of the disease.

Matters needing attention in patients with myocarditis

Patients with myocarditis should first have a full understanding of the disease, reduce the ideological burden, and realize that as long as they cooperate with the doctor's treatment, they will be able to overcome the disease and return to normal life and work as soon as possible. This requires patients to do the following after learning that they have myocarditis:

1. Patients with myocarditis should rest for at least 3 ~ 6 months, patients with dilated heart should rest for at least half a year, and physical activity should be restricted.

2. Strengthen nutrition. Patients with myocarditis should eat a diet rich in vitamins to ensure adequate protein, so as to facilitate the repair of myocardium and promote the recovery of the disease.

3. Preventing colds and colds will aggravate the condition of myocarditis and make relatively stable symptoms recur again, so patients with myocarditis should pay attention to avoiding colds and colds. Once you catch a cold, you should treat it in time to prevent it from further invading the myocardium.

4. Cooperate with the treatment of myocarditis patients should cooperate with the doctor's treatment with a positive attitude, and never take a pessimistic and depressed attitude. Because the prognosis of most myocarditis is good, as long as it is treated properly, it will not leave any sequelae. Patients should take medicine on time, but don't blindly abuse drugs. They should follow the doctor's advice and use drugs rationally.

5. Regular follow-up Patients with chronic myocarditis should go to the hospital for follow-up on a regular basis. You can review ECG and echocardiography to understand the development of the disease and facilitate future treatment.

Pathology and pathophysiology of dilated myocarditis

The heart of dilated myocarditis is often enlarged, especially in bilateral ventricles, so it is called dilated myocarditis. If the heart cavity is slightly dilated, the ventricular wall is slightly thickened, the lesion develops and expands, the ventricular wall is relatively thin, and the thickness of the ventricular wall is normal or slightly thickened. Due to myocardial fibrosis, the myocardial contraction is weak, the ejection fraction is reduced, the semilunar valve orifice may be functionally narrowed, and the left and right ventricles may expand, which may lead to the relative insufficiency of the atrioventricular valve orifice. The atrioventricular valve may be slightly thickened due to repeated blood flow shocks, and myocardial lesions may spread to the endocardium. The local pressure increase of the heart may lead to insufficient blood supply, which may lead to the thickening of plaque-like fibers in the endocardium. About 60% of cases have mural thrombosis.

The coronary artery is normal, or there are atherosclerotic lesions suitable for the patient's age. Under the light microscope, myocardial cells with different degrees of hypertrophy, uneven arrangement and enlarged nuclei can be seen, and half of the cases have focal fibrosis. Under electron microscope, the nucleus of myocardial cells increased, and the number of mitochondria, nucleoprotein, glycogen granules and myofibrils increased, suggesting that the anabolism of myocardial cells was vigorous. In dilated myocarditis, the heart cavity is obviously enlarged, but the ventricular wall is not obviously thickened, the ventricular wall is weak, the contraction is weak, the ejection fraction decreases, the stroke volume decreases, the residual blood volume in the heart cavity increases, the ventricular end diastolic pressure increases, and the pulmonary blood return is blocked, thus causing pulmonary congestion and left heart failure. About 1/3 of this disease begins with left heart failure, and some begin with complete heart failure. In the enlarged heart cavity, there is mural thrombosis, so arterial embolism is very common. Because myocardial fibrosis can involve pacing and conduction system, it is easy to cause arrhythmia.

Myocarditis caused by bacterial infection

Some myocarditis can be caused by direct bacterial infection, or the effect of toxins produced by bacteria on myocardium, or allergic reactions caused by bacterial products.

Myocardial abscess is often caused by purulent bacteria, such as staphylococcus, streptococcus, pneumococcus and meningococcus. Suppurative bacteria come from metastatic colonies of septic septicemia or suppurative thromboembolism of bacterial endocarditis. Visually, there are many small yellow abscesses on the surface and section of the heart, and there are blood bands around them. Microscopically, myocardial cells in the abscess are necrotic and liquefied, and there are a large number of pus cells and bacterial colonies in the abscess cavity. There are different degrees of degeneration and necrosis in the myocardium around the abscess, and neutrophils and monocytes infiltrate in the stroma.

Diphtheria can produce exotoxin, on the one hand, it blocks the protein synthesis of nucleosomes in myocardial cells, on the other hand, it transports long-chain fatty acids into mitochondria through carnitine, which leads to fatty degeneration and necrosis of myocardial cells. Microscopically, focal myocardial degeneration and necrosis were observed, and myocardial cells showed eosinophilic degeneration, sarcoplasmic coagulation, steatosis and sarcoplasmic lysis. Lymphocytes, monocytes and a few neutrophils can be seen in the lesion. Lesions are more common in the right ventricular wall, and tiny reticular scars are formed after healing. In some cases, diffuse myocardial necrosis may lead to sudden cardiac death.

Acute non-rheumatic myocarditis can be complicated with upper respiratory tract streptococcal infection (acute angina pectoris and tonsillitis) and scarlet fever. Its pathogenesis is not clear, and it may be caused by streptotoxin. The lesion is interstitial myocarditis. Microscopically, lymphocytes and monocytes infiltrated around myocardial interstitial connective tissue and small blood vessels, and myocardial cells degenerated and died to varying degrees.

Diet regulation of myocarditis

The diet of patients with myocarditis should be high in protein, calories and vitamins. Eat more glucose, vegetables and fruits. Avoid overeating and avoid spicy, smoked and fried products. When smoking, nicotine in tobacco can promote coronary artery spasm and contraction, affect myocardial blood supply, and drinking alcohol can cause vascular dysfunction, so we should quit smoking and drinking alcohol. You can take chrysanthemum porridge, ginseng porridge and so on in your diet. And you can take sun-dried ginseng and American ginseng according to the doctor's advice, which is beneficial to the recovery of myocarditis.

Eat more fresh vegetables: eat more fresh vegetables and vegetables with high calorie and high protein.

It should be light: it is not advisable to eat salty and spicy food, so as not to increase the burden on the heart.

What should viral myocarditis pay attention to with fever?

Children's myocarditis can be caused by many factors, such as viral infection, bacterial infection and rheumatic myocarditis. Others, such as quinidine, ipecac, hypokalemia, hyperkalemia and so on. , can cause myocarditis. Viral myocarditis is a common clinical disease in children, which can be accompanied by fever before and during the onset. So what is the relationship between fever and this disease? What should you pay attention to when you have a fever?

Because viral myocarditis is caused by viral infection, the disease often has a history of viral infection 1 month before the onset, and children can show fever, accompanied by sore throat, myalgia, abdominal pain, rash and so on. Therefore, children's fever should not be taken lightly at ordinary times, and heart signs should be paid attention to for more serious virus infection, and drugs should be added to protect myocardium when necessary.

In the course of viral myocarditis, children are easily infected with fever because of their poor constitution and poor defense ability. At this time, we should actively control infection, choose effective antibiotics and drugs to protect myocardium, such as a lot of vitamin C, and ask the children to stay in bed to reduce the burden on the heart and help them recover.

Harm of myocarditis

Myocarditis is a relatively harmful disease. What are its specific hazards?

After proper treatment, most patients will not leave any symptoms or signs after recovery.

Very few patients died of severe arrhythmia, acute heart failure and cardiogenic shock in the acute stage. After several weeks or months, the condition of some patients tends to be stable, but there are some cardiac enlargement, cardiac dysfunction, arrhythmia or ECG changes. This situation lasted for a long time, which is roughly the sequela of myocardial scar formation after acute phase.

Some patients turned to chronic myocarditis due to persistent inflammation after acute phase, and gradually developed progressive cardiac enlargement, cardiac insufficiency and arrhythmia, and died of the above complications several years or one or twenty years later. It is difficult to determine the time division of each stage. Generally, it can be an acute period within 6 months, a recovery period from June to 1 year, and a chronic period above 1 year. It is difficult to distinguish chronic patients with unclear acute phase from cardiomyopathy. According to current knowledge and available evidence, some cardiomyopathy evolved from myocarditis.

Health guide for patients with myocarditis

1. Prevention of infection: Viral myocarditis is caused by viral infection. It is very important to prevent the invasion of viruses. Especially to prevent respiratory tract infection and intestinal infection. People who are prone to colds should pay attention to nutrition, avoid overwork and choose appropriate physical activities to enhance their physique. Avoid going out unnecessarily. When you have to go out, you should pay attention to keep warm and eat healthily. Wear a mask during the cold epidemic and avoid going to crowded public places.

2. Combination of work and rest: physical fatigue caused by sudden emotional excitement or excessive physical activity should be avoided, which will reduce the body's immunity and disease resistance.

3. Appropriate rest: generally, you should stay in bed for 2-4 weeks during the acute attack, and you should still rest for 2-3 months after the acute attack. Severe myocarditis with enlarged cardiac boundary should be rested for 6 to 12 months until the symptoms disappear and the cardiac boundary returns to normal. Myocarditis sequela people can live and work as normal as possible, but don't read, work or even stay up late for a long time.

4. Diet adjustment: The diet should be high in protein, calories and vitamins. Eat more glucose, vegetables and fruits. Avoid overeating and avoid spicy, smoked and fried products. When smoking, nicotine in tobacco can promote coronary artery spasm and contraction, affect myocardial blood supply, and drinking alcohol can cause vascular dysfunction, so we should quit smoking and drinking alcohol. You can take chrysanthemum porridge, ginseng porridge and so on in your diet. And you can take sun-dried ginseng and American ginseng according to the doctor's advice, which is beneficial to the recovery of myocarditis.

5. Physical exercise: In the recovery period, if you take proper exercise according to your physical strength, such as walking, aerobics, qigong, etc., you can recover as soon as possible to avoid sequelae. As long as myocarditis sequela has no serious arrhythmia, he can take part in general physical exercises, such as jogging, dancing, Hexiangzhuang Qigong and Tai Ji Chuan. Persistence is definitely good for the recovery of the disease.