Difficulties in diagnosing acute myocarditis by the example of a patient with decompensated chronic heart failure
Background. Myocarditis is defined as myocardial inflammation that can progress to inflammatory cardiomyopathy with concomitant cardiac remodeling and dysfunction due to chronic inflammation. Myocarditis can present with many different symptoms and often mimics other common heart diseases. Thus,...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Penza State University Publishing House
2024-11-01
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| Series: | Известия высших учебных заведений. Поволжский регион: Медицинские науки |
| Subjects: | |
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| Summary: | Background. Myocarditis is defined as myocardial inflammation that can progress
to inflammatory cardiomyopathy with concomitant cardiac remodeling and dysfunction
due to chronic inflammation. Myocarditis can present with many different symptoms
and often mimics other common heart diseases. Thus, it is often difficult to diagnose myocarditis
based on clinical symptoms. However, it is important to get diagnosed as early as
possible as treatment varies greatly and can significantly improve outcomes and prevent the
disease from progressing to dilated cardiomyopathy or heart failure. The purpose of the
study is to consider, using a clinical case as an example, the features of management and
clinical hypotheses of the causes of decompensation of heart failure. Materials and methods.
A clinical example of a favorable outcome of acute myocarditis with the development
of severe heart failure in a patient with erroneously diagnosed dilated cardiomyopathy is
given. Based on the information available at the present stage of development of medical
science, the reasons for incorrect diagnosis are considered, the possibilities of verifying the
correct diagnosis, treatment tactics and prospects for improving the diagnosis and treatment
of such patients are discussed. Results. This clinical case demonstrates the high effectiveness
of conservative therapy for CHF, its almost complete regression in a relatively short
period. Diagnostic hypotheses about the presence of dilated cardiomyopathy (presumably
of toxic-alimentary origin) and PICS n/a in the patient do not seem to be valid, since even
the use of the most comprehensive therapy for CHF in a short period (3 months of therapy)
cannot lead to restoration of LV systolic function, probable disappearance zones of hypokinesia
and akinesia, as well as to significant clinical regression of symptoms and the patient’s
return to their usual lifestyle. Conclusions. Taking into account the above analysis, it
seems to us that the development and decompensation of CHF in this patient was based on
acute infectious myocarditis, as a complication of severe bilateral polysegmental pneumonia
suffered by the patient. |
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| ISSN: | 2072-3032 |