Myocardial Diseases

Description. Clinical Picture. Evolution and Prognostics. Treatment.

Myocardial DiseasesĀ are inflammatory and non-inflammatory diseases of the heart muscle.

Inflammatory affections of the heart and non-inflammatory affection of the heart are called myocarditis. These may evolve to dilated cardiomyopathy.

Myocarditis occurs in diphtheria, typhoid fever, scarlet fever, angina, exanthematic typhus, virosis, allergies. A particular clinical form is primary or idiopathic acute myocarditis (described by Friedler) with fever, heart failure and fatal outcome in a few weeks.

Myocardiopathies bring together many causes.

Excluding ischemic myocardiopathy, secondary myocardiopathies occurr in some vitamin deficiencies, electrolyte disturbances, endocrine disorders, anemias and dysproteinemia, lupus erythematosus, hemochromatosis and primitive myocardiopathies with unknown etiology and pathology are described.

Clinical picture

The clinical picture of Myocardial disease is variable, with some symptoms related to myocardial injury, other than causal affection.

In myocarditis, myocardial syndrome is common: tachycardia, functional apical systolic breath, noise reduction, rhythm and conduction disorders, alternating pulse, heart enlargement.

Heart failure may be left, right or global, acute or chronic. In myocardiopathies the clinical appearance is varied, sometimes asymptomatic, sometimes there is ventricular hypertrophy, rhythm or conduction disorders, heart failure.

Hemodynamic, hypertrophic, obstructive, restrictive or congestive form is described. Evolution and prognosis depend on etiology. Myocarditis usually heals.

Prognosis is reserved in myocardiopathies, especially in primitives.

Treatment

Treatment of myocardial diseases can vary in relation to aetiology. In subaortic stenosis and idiopathic hypertrophy, adrenergic beta-blockers are indicated.

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