Dr. Edward Mekenyan: Viral infections cause myocarditis

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Dr. Edward Mekenyan: Viral infections cause myocarditis
Dr. Edward Mekenyan: Viral infections cause myocarditis
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Dr. Eduard Mekenyan is a cardiologist specialist at the Cardiosurgical Hospital "Ajibadem City Clinic" - Burgas

What factors provoke the occurrence and development of myocarditis? Why is it important to recognize this disease in its acute phase? How is it treated? What is prevention? See the answer to these and other questions in the interview with Dr. Mekenyan.

Dr. Mekenyan, what is myocarditis and for what reasons does it arise and develop?

- Myocarditis is an inflammation of the heart muscle, the myocardium. This inflammation can be caused by many different reasons, which, in general, are grouped into two large groups - non-infectious and infectious. Non-infectious agents are many and varied, generally speaking. Such are some volatile materials, poisons, lead, mercury, etc. Certain medications can also be toxic to the heart, especially some of those used for chemotherapy in the treatment of cancer - cytostatics, for example. As well as some antibiotics, but I'll note again, this is generally speaking.

Infectious agents deserve more attention, which again are two groups - bacteria or viruses, but most often viruses are the ones that provoke the occurrence of myocarditis. More interesting to your readers is the fact that standard viral infections can cause myocarditis.

But the mentioned medicines should not bother the people who are treated with them, isn't that what you mean?

- That's right. We should not scare people, they are already sensitive about the side effects of drugs. These medications that I mentioned are necessary and used in the treatment of serious diseases. Unfortunately, nothing is completely harmless, so people should not be afraid of the possible side effects of the drugs they have to take.

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How does myocarditis manifest itself? Are there initial signs, what are the subsequent symptoms?

- This disease manifests itself extremely insidiously. Very often it starts with a standard viral infection: with pain in the muscles, in the joints, with general malaise, general fatigue, chills, fever. 2, 3, 4 days pass, these general symptoms disappear, then they reappear and are again associated with the general viral condition, i.e., with the first virosis. Very often, however, this is already associated with the inflammation of the myocardium itself. The symptoms are almost the same, butis also added

heartbeat skip heart

too. Patients report a feeling of shortness of breath that they are not used to. Especially younger patients. I want to note that this disease occurs more often in active people.

Why does it affect young people more often?

- It's just that young people don't take care of themselves enough, they are more in contact and get sick from this type of disease more often. This is what the reports show - myocarditis is a disease that mostly affects young, active people and more often - men.

Myocarditis is not a seasonal disease, although it is more often associated with flu seasons. I have seen cases of myocarditis throughout the year, I would say the frequency is the same.

Is acute or chronic myocarditis more dangerous? And what is being done as a treatment?

- See, it is much more important to recognize the disease in the stage of acute myocarditis. Because then there will be the greatest benefit from the measures being taken. There is no specific treatment for myocarditis, this should be known. There are many studies, according to some of them antiviral drugs, immunosuppressants have a good effect. But so far there is no reliable evidence that they act purely targeted as an etiological treatment. Therefore, the main treatment of myocardium is related to the impact of the manifestations of heart failure. Because when the muscle of the heart becomes inflamed, it ceases to contract with the power with which it previously regulated it. Traction drops and patients have signs of heart failure. In fact, the treatment is for the symptoms of heart failure. And perhaps the most important thing to know about the treatment of myocarditis is an extremely limited physical regimen. I.e. this heart must work at the most optimal rpm, the lowest rpm. Because it is very hurt and vulnerable precisely in this period. Any physical exertion can lead to

relaxation of the heart muscle,

to cavity dilatation. And when that happens, it's pretty hard to go back.

What can happen if the acute phase of myocarditis is not caught?

- If we catch it in the acute phase, we doctors know what needs to be done. But if it is not recognized (as I mentioned, these are relatively young people, they are active people and lead a standard lifestyle), then gradually the manifestations of heart failure deepen, the heart relaxes. The disease enters a chronic phase, which means that the return of this muscle to its previous form is almost impossible.

What can we say about the prevention of myocarditis?

- Prevention is mainly expressed in its early recognition. This is the real prevention. Otherwise, of course, the general prevention of viral infections is known - a good way of eating, physical activity. Colleagues know, but let your readers also know that everyone who is on chemotherapy with cardiotoxic effects must consult a cardiologist. Mandatory to give them an ultrasound assessment of the condition. This can also be taken as a preventive measure.

In the end, if an infection does not go away, but deepens, you must go to a cardiologist - right?

- Yes, in the presence of a protracted infection that is difficult to treat; which is associated with skipping of the heart; with palpitations; especially if it is associated with the appearance of shortness of breath during physical exertion or nocturnal shortness of breath, which makes the patient cough and forces him to sit down because he is short of air - this is an extremely characteristic symptom and it is necessary for this person to get to cardiologist. Any infection that lasts longer and is associated with more complicated symptoms, i.e., it is not just the banal temperature and general weakness, but there is already shortness of breath, palpitations and even pain in the heart - it implies a mandatory consultation with a cardiologist.

the most interesting thing is that myocarditis in its acute phase is one of the reasons for doing the so-called false coronary angiography. I say "false" because the disease in its acute phase closely resembles a myocardial infarction. And it is very difficult just by looking at the patient to judge whether it is myocarditis. We may have strong suspicions that it is the myocardium, and it turns out to be a heart attack. Therefore, very often coronary angiography is done simply to rule out a heart attack. To make sure our behavior is correct. Because if we miss a heart attack, that's already a pretty big mistake.

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The most severe complications of atherosclerosis

“The atherosclerotic process is not a limited process, it affects four groups of organs: heart, brain, limbs, internal organs. I can talk about the complications for the heart from atherosclerosis, and I will immediately say that the main complication is myocardial infarction. As well as advanced ischemic heart disease. Heart attack is the most dangerous because it is a debilitating disease. The so-called multibranch coronary disease is also a result of progressive atherosclerosis. It is a disease that slowly and gradually leads to relaxation of the heart muscle, to heart failure and then to death. All this is a consequence of atherosclerosis.

People who read should know that it is necessary to prevent atherosclerosis, because after that it is already a little late, there is something to be done, but it is late. Atherosclerosis processes should be prevented. Atherosclerosis can occur even with the most correct lifestyle possible. But there are also processes that accelerate it - I'm talking about diabetes, high blood pressure, high cholesterol, smoking, immobility. All these things accelerate atherosclerosis, commented the expert.

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