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: T.M. Shibaeva, A.E. Sheina, T.N. Belugina, E.S. Fokina, M.A. Saakyan
Format: Article
Language:English
Published: Penza State University Publishing House 2024-11-01
Series:Известия высших учебных заведений. Поволжский регион: Медицинские науки
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author T.M. Shibaeva
A.E. Sheina
T.N. Belugina
E.S. Fokina
M.A. Saakyan
author_facet T.M. Shibaeva
A.E. Sheina
T.N. Belugina
E.S. Fokina
M.A. Saakyan
author_sort T.M. Shibaeva
collection DOAJ
description 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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series Известия высших учебных заведений. Поволжский регион: Медицинские науки
spelling doaj-art-5343910079144dee9077ca18655537582025-08-20T02:27:46ZengPenza State University Publishing HouseИзвестия высших учебных заведений. Поволжский регион: Медицинские науки2072-30322024-11-01310.21685/2072-3032-2024-3-9Difficulties in diagnosing acute myocarditis by the example of a patient with decompensated chronic heart failureT.M. Shibaeva0A.E. Sheina1T.N. Belugina2E.S. Fokina3M.A. Saakyan4Penza State UniversityPenza State UniversityPenza State UniversityPenza State UniversityPenza State UniversityBackground. 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.acute myocarditissevere heart failuredilated cardiomyopathy
spellingShingle T.M. Shibaeva
A.E. Sheina
T.N. Belugina
E.S. Fokina
M.A. Saakyan
Difficulties in diagnosing acute myocarditis by the example of a patient with decompensated chronic heart failure
Известия высших учебных заведений. Поволжский регион: Медицинские науки
acute myocarditis
severe heart failure
dilated cardiomyopathy
title Difficulties in diagnosing acute myocarditis by the example of a patient with decompensated chronic heart failure
title_full Difficulties in diagnosing acute myocarditis by the example of a patient with decompensated chronic heart failure
title_fullStr Difficulties in diagnosing acute myocarditis by the example of a patient with decompensated chronic heart failure
title_full_unstemmed Difficulties in diagnosing acute myocarditis by the example of a patient with decompensated chronic heart failure
title_short Difficulties in diagnosing acute myocarditis by the example of a patient with decompensated chronic heart failure
title_sort difficulties in diagnosing acute myocarditis by the example of a patient with decompensated chronic heart failure
topic acute myocarditis
severe heart failure
dilated cardiomyopathy
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AT aesheina difficultiesindiagnosingacutemyocarditisbytheexampleofapatientwithdecompensatedchronicheartfailure
AT tnbelugina difficultiesindiagnosingacutemyocarditisbytheexampleofapatientwithdecompensatedchronicheartfailure
AT esfokina difficultiesindiagnosingacutemyocarditisbytheexampleofapatientwithdecompensatedchronicheartfailure
AT masaakyan difficultiesindiagnosingacutemyocarditisbytheexampleofapatientwithdecompensatedchronicheartfailure