5-year-old children suffering from myocarditis, how to treat, how to care?

The incidence of viral myocarditis in children is high and the harm is great, which attracts the attention of parents.

The "culprit" of viral myocarditis is virus, and the most common one is enterovirus called Coxsackie. Other viruses that can cause superficial diseases of respiratory tract and intestine, such as adenovirus and echovirus, can also cause viral myocarditis.

Viruses can damage the heart in two ways: one is that after the virus enters the body, it reaches the heart with the blood flow and directly enters the myocardial cells, causing damage to the cells; The other is that after the virus dries the main body, it induces the body to produce some substances that harm myocardial cells, so that myocardial cells are damaged.

At present, it is believed that the above two pathways are involved in the occurrence and development of viral myocarditis. The former often appears in the early and acute stages of the disease, while the latter often appears in the late and chronic stages.

There are three common modes of viral myocarditis, namely, common type, fulminant type and occult type.

Generally, there is a history of respiratory or intestinal infections, such as colds and diarrhea, before the onset 1-2 weeks, and then symptoms such as chest tightness, shortness of breath, fatigue and pale face appear. When you go to the hospital for examination, you may find signs such as enlarged heart, depressed heart or arrhythmia.

Outbreaks often have no premonitory symptoms and signs, and they are fierce. Clinically, it is often characterized by sudden convulsions, which is called "Asperger's syndrome" in medicine. This is due to viral myocarditis, which leads to the decrease of heart pumping and convulsion caused by cerebral ischemia and hypoxia. The fulminant type can also be manifested as a sudden drop in blood pressure during heart failure and cardiogenic shock.

The occult cause has no obvious past history of respiratory and intestinal infections, and people often feel uncomfortable after fatigue. I went to the hospital for examination and found that my heart was enlarged and my heart function was decreased. The most common clinical mode of onset is common, but fulminant and occult are the greatest threats to children, which should be paid attention to by parents and clinicians.

The diagnosis of viral myocarditis should not only pay attention to the above manifestations, but also rely on ECG and blood biochemical examination. There is arrhythmia on ECG recently, so myocarditis should be considered. If it can be combined with clinical symptoms and signs, it is more meaningful for diagnosis. However, it should be noted that viral myocarditis can never be diagnosed only by arrhythmia on ECG, otherwise some simple arrhythmia will be misdiagnosed as viral myocarditis, which will invisibly increase the mental and economic burden for children and parents.

The most commonly used indexes in blood biochemical examination are myocardial zymogram and cardiac troponin. It should be emphasized that the normal values of myocardial enzymes used in many hospitals are adult standards, but in fact, the normal values of myocardial enzymes in children are higher than the normal values of adults, and viral myocarditis cannot be diagnosed just because the myocardial enzymes are higher than the normal reference values. Because there are many factors affecting myocardial enzyme spectrum, the accuracy is not high. At present, many hospitals have developed methods to detect cardiac troponin to assist in the diagnosis of viral myocarditis. Practice has proved that it can really improve the accuracy of the diagnosis of viral myocarditis.

In a word, the diagnosis of viral myocarditis is a comprehensive process, and it can't be diagnosed only by one examination or one index. For some complicated cases, more advanced and expensive examination instruments and means may be needed. Endocardial myocardial biopsy is helpful to definite diagnosis and provide reliable basis for effective treatment.

What should parents of children with viral myocarditis pay attention to?

First of all, don't produce excessive mental stress, so that children can establish confidence in overcoming diseases. We should know that with the development and progress of modern medicine, most children can be treated, a considerable number of children can be completely cured, and only a few children will develop chronic myocarditis or dilated cardiomyopathy.

Secondly, try to let children stay in bed, eat more digestible food and eat more fruits.

Third, actively cooperate with doctors for treatment. Generally, viral hepatitis is treated in hospital for about 3 weeks, and then it can be treated at home. Because of the particularity of virus damage to the heart, its recovery period is longer than that of virus damage to other organs, usually 3 months to half a year. During this period, some children will insist on studying at school because they don't want to delay the course, but they should be careful not to be too tired, limit their physical activities appropriately, and go to the hospital for regular review.