Cardiovascular diseases of various etymologies are quite common among cardiovascular diseases. Carditis is a common name for inflammatory diseases of the heart.
It occurs quite often, regardless of the age of the patient, including newborns and older children. Has a symptomatology that is not specific for cardiovascular diseases, is dangerous for complications.
Inflammatory process can be covered myocardium, epicardium, endocardium, pericardium.
Classification and reasons
To understand what it is - carditis, it is worth exploring their types and shapes. Classify them according to different signs. First of all, rheumatic and non-rheumatic.
Rheumatic carditisdevelops against the background of a systemic autoimmune disease - rheumatism. In this case, all the membranes of the heart are involved in the pathological process, first the myocardium is affected, as a result of which endocarditis and pericarditis can occur.
In 20-25% of cases, the disease leads to acquired heart disease.The majority - 59% of the number of cases - due to timely active treatment, recovers, there are no changes in the heart.
Non-rheumatic carditisis due to other reasons. Also quite often found in medical practice. Non-rheumatic carditis also affects adults (age and sex do not matter), and children. In the latter, non-rheumatic carditis occurs more frequently than in the adult category.
According to experts,0.5% of all hospitalized are children with non-rheumatic carditis. Autopsy of the deceased minors shows 2.3-8% of carditis. The percentage can grow to 10-15 if a viral infection is confirmed.
The photo shows the classification of carditis for the localization of inflammation:
Non-rheumatic carditis has the following etology:
- Viral. It is produced by viruses of influenza, poliomyelitis, rubella, chicken pox, adenoviruses; enteroviruses - herpes, Coxsackie, ECHO.
- Bacterial. Reason: typhoid fever or diphtheria.
- Allergic. Reason: drugs, vaccine, whey.
- Fungal. Reason: coccidiomycosis.
- Parasitic. Reason: toxoplasmosis, histoplasmosis, schistosomiasis.
- Unknown etymology.
By the period of occurrence:
- congenital;
- acquired.
Congenital carditis is early or late, are determined in newborns in the first days or months of life. Reason: intrauterine viral / bacterial infection carried by the mother during pregnancy.
Acquired carditisoccur in infants due to infection with a viral, bacterial infection or rheumatic attack.
By the duration of the current:
- acute (inflammatory process lasts less than three months)
- subacute (inflammation lasts up to eighteen months)
- chronic (the disease takes more than a year and a half)
Symptoms and signs
Primary symptomatology of inflammation of the heart membranes is difficultand requires special attention of the attending physician. The nature of the course of the disease rarely directly indicates a problem with the heart. Especially in cases of acquired carditis after an infectious disease.
The development of the process gives morecertain signs of cardiac pathology: tachycardia, arrhythmia, deafness of cardiac tones, dyspnea, edema, cyanosis.
But they also often coincide with the characteristics of other cardiovascular diseases, such as mitral stenosis, arrhythmia of extracardiac origin, rheumatism, heart disease, tumor processes in the myocardium.
In children, carditis is accompanied by a cough, pain in the region of the heart. To say about the pain the child can not, he tries to avoid sudden movements, to breathe superficially.
Confirm the diagnosis persisting for a long timeat ECG results signs of conduction and automatism violationalong with other indicators that speak of hypertrophy of the left heart and myocardial ischemia. X-ray reveals changes in the shape, increase in the cardiac tissue of the left ventricle, slowed pulsation (80-85% of patients).
What kind of doctor should I contact?
Treatment of heart diseasescardiologist. It is he who will make an accurate diagnosis, prescribe a qualified treatment. When identifying the specificity of the disease, a specialist can continue the treatment, for example,cardiorevmatologist.
The primary diagnosis of problems with the heart is the therapist. At the slightest suspicion, he will send the patient to the cardiologist.
In case of a viral illness, signs of carditis should be revealed by the infectious disease specialist and also redirect the patient to a consultation with a cardiologist.
Tactics of treatment
The disease is treated in a complex and phased manner.It takes a long time. The doctor takes into account all the nuances: the severity of the process, how timely the patient turned for help, in what form the disease occurs, what was his cause, as well as the age of the patient, his general physical condition.
In acute or severe exacerbation of chronic carditis, hospitalization is required for 10-14 days and up to 1 month. In the first acute phase, etiotropicantibacterial preparations. The patient observes strict bed rest.
Requiredspecial diet- products enriched with potassium salts, vitamins (recommended: baked potatoes, dried apricots, raisins), limited consumption of salt. Do not eat foods that delay the removal of fluid from the body to prevent swelling. If the disease is severe, prescribe oxygen therapy.
In the first two months of treatment, the patient takesanti-inflammatory non-steroid drugs- indomethacin, voltaren in a complex with vitamins, antihistamine drugs and potassium. Diuretics are often prescribed.
In severe prolonged disease, the doctor may prescribe prednisolone. In case of heart failure cardiac glycosides are shown. If signs of intravascular coagulation appear,drugs that improve microcirculation and metabolic processes in the myocardium. Possible antiarrhythmic therapy.
When the process passes an acute period, a person is recommendedexercise therapy.
butsignificant physical activity is strictly contraindicated. Children are exempt from physical education and subbotniks. Preventive vaccinations are possible not earlier than five years and after consulting with a cardiologist.
Alsorecommended restorative treatment in special sanatoriums of cardiological profile. A cardiologist or cardiothorematologist monitors the patient during the year: routine examinations are performed and an ECG is administered every three months.
Forecast
The prognosis for inflammation of the membranes of the heart depends on many factors:health status and age of the patient, the state of his immune system, timeliness and literacy of treatment, hereditary predisposition, adherence to doctor's recommendations and preventive measures.
Only when a year or two a person has completely disappeared all signs of an inflammatory disease of the membranes of the heart, he is considered fully cured. Such an outcome of the disease is observed more oftenin acute form of carditis.
In the subacute course of the disease or its chronic variant, carditis has a prolonged course, which is fraught with various complications: arrhythmia, pulmonary hypertension, myocardial hypertrophy and cardiosclerosis.
Prevention
Specialists share preventive measures to prevent carditis on primary and secondary.
Primary
Primary prevention means measures to prevent the onset of the disease. With rheumatic carditis, prevention is primarily aimed at preventing the occurrence and development of rheumatism in the human body.
Practically thiscomplex of restorative actions, such as hardening, exercise, a balanced diet, intake of vitamins, etc.
In cases of non-rheumatic carditis, the goal of prevention -prevention of infection with different types of infections. Particular attention is required in periods of epidemics. A set of measures: restorative and revitalizing procedures, the intake of vitamins and drugs that increase immunity.
In pediatrics, primary prevention ismeasures to prevent the infection of pregnant women with infections, identification and sanitation of foci of infection in the body of a future mother, compliance with vaccination rules. Particular attention is paid to risk groups: pregnant women with hereditary heredity, cardiovascular diseases.
Prevention of carditis in children: hardening of the newborn, dispensary supervision of children at risk.
Secondary
Secondary prevention includes a number of measures to prevent recurrences and complications.Constant observation of specialists, timely diagnosis, therapy, courses of preventive treatment.
When rheumatic carditis ispreventive measuresrheumatism. Usually include the administration of prolonged action antibiotics (bicillin, penicillin, retarpen, pendepon).
Carditis is a disease that is successfully treated by modern medicine. Nevertheless, the risk of complications remains serious in all age groups of patients. In order not to earn a chronic cardiovascular disease,should promptly turn to specialists, accurately describe all the disturbing symptoms, require in-depth examination, timely diagnosis and treatment.
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