Fulminant myocarditis is a disease that occurs rapidly and progresses rapidly, and viral infection is the main cause, which can cause myocardial damage in a relatively short period of time. Young adults under the age of 40 are a high incidence of fulminant myocarditis, a disease that can quickly lead to heart failure or severe arrhythmias, and with the failure of multiple important organs, the fatality rate can be as high as 50%, accounting for more than 70% of the number of sudden cardiac deaths. Let's introduce the key points of identification of this disease to you now.
Myocarditis is a function impaired by myocardial inflammatory injury caused by various causes. Fulminant myocarditis, also known as acute severe viral myocarditis, viral infection is the main cause, however, due to the limitation of detection methods, only 10% to 20 of the fulminant myocarditis patients in the myocardial tissue, can detect the virus, common virus types, mainly including influenza virus, adenovirus, coxsackievirus.
The virus causes myocardial damage, mainly through direct injury and immune damage. Direct injury refers to the virus invading cardiomyocytes and replicating within the cells, causing myocardial degeneration and necrosis, and after the cells are lysed, the virus will continue to infect other cells and tissues, and release cytokines, causing more serious damage. Immune damage refers to cytokines causing inflammatory edema, as well as cytotoxic reactions and antigen-antibody reactions, causing damage to the myocardium.
Fulminant myocarditis, with a high fatality rate, is associated with disease manifestations. Usually, before the outbreak of myocarditis, there will be symptoms such as fever, fatigue, nasal congestion, runny nose, sore throat, cough, diarrhea, etc., and the patient himself, even the doctor, will be treated as a severe cold when he encounters such manifestations. This is the main cause of misdiagnosis or missed diagnosis. Therefore, if you feel cold, the symptoms continue to worsen, and you need to be extra careful when you have symptoms such as severe fatigue or chest tightness.
In fulminant myocarditis, within a few days to 3 weeks after the onset of prodromal symptoms, symptoms such as shortness of breath, dyspnea, chest tightness, chest pain, palpitations, dizziness, extreme fatigue, and decreased appetite will occur. Some patients will quickly develop shock manifestations, with wet and cold skin, pallor, cyanosis, skin spots, and impaired consciousness. If it causes functional impairment of other organs, symptoms such as abnormal liver function, renal failure, and changes in coagulation function may occur, and a small number of patients may develop syncope or sudden death.
Fulminant myocarditis can cause hemodynamic changes, changes in blood pressure, breathing, heart rate, etc., and the increase in heart rate is not commensurate with the magnitude of the increase in body temperature, for example, the usual fever, for every 1 degree Celsius increase in body temperature, the heart rate increases by about 10 times, but patients with fulminant myocarditis may rapidly develop arrhythmias. ECG is less sensitive and specific for the diagnosis of fulminant myocarditis because the associated findings are similar to those of acute myocardial infarction. Echocardiography and cardiac magnetic resonance imaging have high reference value for diagnosing fulminant myocarditis and judging the progression of the disease.
To deal with fulminant myocarditis, first of all, it is necessary to identify and confirm the disease in time, at the same time, the patient should rest, reduce the workload of the heart, strengthen myocardial nutrition, and carry out antiviral, immune regulation, auxiliary circulatory support and other treatments, timely understand the situation of lung inflammation and pleural effusion, usually need to use glucocorticoids and gamma globulin as soon as possible, and can also clear the pathogenic factors in the plasma through immunosorbent therapy, reduce myocardial inflammation, and improve heart function. During treatment, patients need absolute bed rest, avoid mood swings, and a diet that is nutritious and light. Finally, once again remind everyone, especially young friends, if you encounter a cold, the condition continues to worsen, and there is body aches and weakness, as well as chest tightness, breathing difficulties and other symptoms, you need to seek medical examination in time to exclude fulminant myocarditis, so as not to delay the timing of treatment.
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