儿科心血管系统 viral myocarditis英文课件.ppt

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1、2020年10月2日,1,Viral Myocarditis,第一课件网站,2020年10月2日,2,IntroductionMyocarditis:Myocarditis is defined as inflammatory changes in the heart muscle and is characterized by myocyte necrosis.There are all kinds of causes and viral infections are the most common cause.,2020年10月2日,3,Etiologies and Pathogenesy

2、,Virus infection:The most common causes of myocarditis are coxsackie A and B,echovirus,adenovirus and cytomegalovirus.Directly damageAuto-immunoreaction,2020年10月2日,4,Clinical manifestation,Symptoms:The presentation depends on the patients age and the acute or chronic process.fatigue,pale,chest malai

3、se,myalgias,bellyache etc.Severe case:CHF,severe cardiac arrhythmia,cardiogenic shock,sudden death etc.Signs:tachycardia,cardiac dilatation,heart sounds may be muffled and distant,gallop,signs of CHF and signs of cardiogenic shock.,2020年10月2日,5,Cardiac enzyme levels:CPK,LDH,CK-MB,cTnT、cTnI Electroca

4、rdiogram:cardiac arrhythmiapremature beat,tachycardia,AV block,ST-T Chest radiography:large cardiac sihouette,pulmonary venous congestion,edema,Auxiliary Examination,2020年10月2日,6,Auxiliary Examination,Echocardiography:cardiomegaly,ventricular disfunction,heart function pericardial effusion ect.Virol

5、ogy examination:viral isolation,specific antibody,PCR identification of a viral infection,myocardial biopsy etc.,2020年10月2日,7,Diagnosis Diagnosis may require blood tests,a chest X-ray,electrocardiogram or radionuclide angiocardiogram,and,in rare cases,biopsy of a tissue sample from the heart muscle.

6、,2020年10月2日,8,Diagnosis,Clinical Findings 1.heart disfunction,cardiogenic shock or cardio-cerebral syndrome 2.cardiac dilatation(chest radiography,echocardiography)3.change of electrocardiogram 4.CK-MBor cTnT(+)、cTnI(+),2020年10月2日,9,诊断,心电图改变：以R波为主的2个或2个以上主要导联的ST-T改变持续4天以上伴动态变化；窦房、房室传导阻滞，完全右或左束支传导阻滞；

7、成联律、多源、多型、成对或并行早搏；非房室结、房室折返引起的异位心动过速；低电压、异常Q波。,2020年10月2日,10,Diagnosis,Pathogenies1.Diagnosis indexes:from endocardium,myocardial tissue,or pericardial fluid Viral isolation PCR identification of a viral infection Specific antibody,第一课件网站,2020年10月2日,11,Diagnosis,Pathogenies2.Referenced diagnosis ind

8、exes viral isolation from stool,blood etc IgM(+)PCR identification of a viral infection from blood,2020年10月2日,12,Diagnosis,Diagnosis guidelines1.Clinical diagnosis of myocarditis:2 clinical findings2.Diagnosis of viral myocarditis:2 clinical findings+1 pathogenies of diagnosis indexes3.Clinical diag

9、nosis of viral myocarditis:2 clinical findings+1 pathogenies of referenced diagnosis indexes,2020年10月2日,13,Diagnosis,Exclusion:rheumatism myocarditis toxic myocarditis congenital heart diseases cardiomyopathy endocardial fibroelastosis congenital AV block etc.,2020年10月2日,14,Stages,Acute phase:1y,202

10、0年10月2日,15,Treatment,Rest:3-4w,HD or HF 3-6m.Protect cardiac muscleAntioxidant:VitC,CoQ10,VitEAntivirusCorticosteroids and immunosuppressionOthers,16,演讲完毕，谢谢观看！,Thank you for reading!In order to facilitate learning and use,the content of this document can be modified,adjusted and printed at will after downloading.Welcome to download!,汇报人：XXX 汇报日期：20XX年10月10日,