's prevention and health care of diagnosis of the viral myocarditis

's prevention and health care of diagnosis of the viral myocarditis
[Pathogenesis ] is observed from animal's experiment, clinic, virology, pathology, find that there is the following two mechanism:
(1) Can be with myocarditis after the virus acts on the experiment and injects the virus into the blood circulation directly. With acute issue, 9 day within get up disease mainly, patient or can isolate the virus in the cardiac muscle of animal, the virus fluorogenic antibody inspection result is positive, or find the virus particle when the electric mirror is checked. The virus produces and dissolves the cell material behind infecting myocardium cells, make cells dissolve.
(2) Immunoreaction experimental to get up 9 day after the disease already can't with the intersection of human body and viral myocarditis any more find virus in the cardiac muscling, but myocarditis changes and still goes on; Some the intersection of patient and other slight symptom that virus is infect with and myocarditis display rather serious; Some the intersection of patient and symptom of myocarditis the side appear until virus infect with other the intersection of symptom and some time at the beginning still; May find the antigenic antibody compound the body in some patients' cardiac muscle. The above is briefed on the existence of the immune mechanism. Experimental medium and small the intersection of mouse and myocardium cell infect the intersection of small quantity and strange virus Sa Ke, measure toxicity prominent cell its; If add and use the same kind of immune spleen cells, then cell toxicity is strengthened; If deal with immune spleen cells by resisting antibody of spleen of chest and complement in advance, then cell toxicity is not strengthened; Deal with immune the intersection of spleen and cell with strange the intersection of B and antibody and complement Sa Ke in advance, cell toxicity increase then; The experiment proves viral myocarditis has cells to lie between the immune mechanism led and exist. Study, brief on cell toxicity to lie between, lead by the intersection of T and lymphocyte mainly still. On clinic, viral myocarditis delays the persons who do not heal, E garland, lymphocyte conversion ratio, alexinic C are lower than normal people, resist the nuclear antibody, resist the myocardium antibody, resist the complement higher than normal people's detection rate, the immune function bows while explaining viral myocarditis. Vigor and interferon of the natural killer cell have been normal when finding viral myocarditis recently, interferon of is normal, also reflect it is out of control that there is cell immunity. Little mouse's experimental myocarditis gives immune inhibitor and is infected with to make the condition become more serious to increase with mortality in early days after surrounding the spore mould plain A, give medicine to make mortality reduce after infecting for one week.
The above-mentioned materials brief on viral myocarditis to rely mainly on the fact that the virus act on directly in early days, take immunoreaction as the core later.
Symptom depends on extensive intensity and position of pathological change. The heavy one can be to die suddenly, several of the lighter, without the symptom. Always young can have illness coming on, but apter to have illness coming on with young people. The man exceeds women.
(1) Symptom of symptom myocarditis may present in the symptom period or convalescence having illness coming on originally. Such as appearing in the symptom period having illness coming on originally, it behaves and can be had illness coming on originally and concealed. Most patients have symptom of generating heat, aching all over, swallowing and aching, suffering from diarrhoea etc. before having illness coming on, reflect the whole body virus is infected, light but not prominent symptom that but some patients have illness coming on originally too, must question carefully and then noticed, but myocarditis symptom is more prominent. The myocarditis patient often tells secret anguish, palpitation, weak, sick, dizzy in the district before the heart uncomfortable in chest. In myocarditis diagnosed on clinic, about 90% see symptom for the main suit or for the first time with the arrhythmia, among them a few patients can faint therefrom or A - Sri Lankan's syndrome. A few patients get up after being ill fast growingly, it is in heart failure that appear or heart source shock.
(2) Physical sign 1. Cardiac dilatation the intersection of the lighter and heart does not expand, generally have temporary enlargement, resume. Cardiac dilatation reflects notably myocarditis is extensive and serious.
2.It is unbecoming that the heart rate changes acceleration rate and body temperature of the heart rate, or the heart rate is unusually slow, it is a suspicious sign of myocarditis.
3.The heart sound can be lowered or split while changing the first sound of apex of the heart district. The heart sound can be presented the fetus heart kind. The appearance of the pericardium fricative reflects that there is pericarditis that exists.
4.There may be systolic phase to dry one kind of noises or relaxation and a noise in the apex of the heart of noise district, the former for generating heat, anaemia, heart expand due to,that the latter cause by the fact that the left room is expanded relativity mitral stenosis. The miscellaneous stereo degree does not exceed tertiarily. Myocarditis disappears promptly after taking a favorable turn.
5.Rhythm of the heart is not normal and extremely common, various arrhythmia can present, it is most common to fight with the room early with the room, secondly it is the atrio-ventricular block, in addition, the atrium quivers, the morbid state sinus room can present to form syndrome. The arrhythmia is causing one of the reasons to die suddenly.
6.The serious disease filling the air myocarditis patient in heart failure can present acutely and in heart failure, the myocardium pump blood function is depleted, the left and right heart coincides depletedly, causes the heart to arrange blood volume too low, so except that generally in heart failure to behave, it is apt to amalgamate source shock of heart.
[Pathology changes ]
The pathological change range comes in different sizes, can be for the filling the air or limitation. Develop as being acute or chronic with the course of disease. The naked eye of the more seriously one of pathological change sees the cardiac muscle relax very much, gray or yellow, the heart is expanded. Pathological change has not found more than the lighter while checking on the whole, find and depend on diagnosing only under the microscope to some extent, and it must be in a plurality of position section that pathology is checked, and then make pathological change avoid omitting. Under microscope, among the myocardium fiber and can find cell soak in the connective tissueing around the blood vessel, take monocyte as the core. Myocardium cells can be changing the sex, dissolve or necrosis. Pathological change if the district can amalgamate pericarditis, become viral pericardium myocarditis under the pericardium. Pathological change can last cardiac muscle and among quality,it is get up to the rooms form, prop up room room bunch and bunch at room forming, room after fighting and conducting system such as sinus that heart not to can also involve, become the morbidity foundation of arrhythmia. The stronger the virulence of the virus is, the wider the pathological change range is. In experimental myocarditis, can see myocardium base organized by fiber and substituted after cudgelling one's brain.
On the evidence foundation of diagnosing the diagnosis of the viral myocarditis must be set up in the evidence with myocarditis and the virus infects. Uncomfortable in chest and palpitation often can brief heart on, involve, cardiac dilatation, arrhythmia or in heart failure to behave for whom heart obviously damaged, ST-T changes with rhythm of the heart of malposition or conducts the obstacle and reflects the existence of the myocardium pathological change on the electrocardiogram. The evidence that the virus infects has the following points: There is generating heat, diarrhoea or influenza symptom, present heart symptom or electrocardiogram change soon after taking place. Serum virus neutralize antibody, determine positive result, because strange B Sa Ke the most common in virus, measure this group the intersection of neutralization and antibody of virus usually, get up disease fetch the intersection of blood and the intersection of sample and once early period and over 2- 4 o'clock, if antibody result price two times shows 4 times and rise or is greater than or equal to 1 once among them: 640,Can be regarded as the basis infected with this virus recently. Swallow and anus wipe away virus separate, if have auxiliary meaning while being positive, some normal people can also be positive, meaning its must neutralize antibodies, determine the result combine together while being positive. Virus RNA of detection while organizing from excrement and urine, serum or cardiac muscle with the chain reaction law of polymerase. Myocardium to live and examine: Organize doing the virus to measure from the work that is made, virology is checked and helped Help
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