心肌炎PPT.ppt

MYOCARDITIS Xiaohong Tang OUTLINE Definition Etiology Viral Myocarditis DEFINITION Myocarditis ： ※ one kind of myocardial diseases. ※ said to be present when the heart is involved in an inflammatory process. The inflammation may involve： ※ myocytes ※ interstitium ※ vascular elements ※ pericardium DEFINITION ETIOLOGY Infectious agents: bacteria （细菌） parasite（寄生虫） spirochaete（螺旋体） fungus （真菌） rickettsial（立次克体）virus （病毒） ※ Etiology VIRAL MYOCARDITIS ※ Pathology ※ Clinical Manifestations ※ Physical Examination ※ Lab Findings ※ Diagnosis ※ Management Etiology VIRAL MYOCARDITIS Adenovirus Arbovirus Coxsackievirus （柯萨奇病毒） Echovirus Cytomegalovirus Respiratory syncytial virus Encephalomyocarditis virus Human immunodeficiency virus VIRAL MYOCARDITIS PATHOLOGY .1 Patients with viral myocarditis demonstrate a wide spectrum of gross and histological changes: VIRAL MYOCARDITIS PATHOLOGY .2 Gross: ※ The hearts in acute cases are flabby, with focal hemorrhages. ※ In chronic cases, the heart is enlarged and hypertrophied. VIRAL MYOCARDITIS PATHOLOGY .3 Histol: The histological hallmark of viral myocarditis is an inflammatory myocardial infiltrate, with associated evidence of myocyte damage. VIRAL MYOCARDITIS PATHOLOGY .4 Histol: The inflammatory infiltrate in viral infections, lymphocytes are seen in bundance. CLINICAL MANIFESTATIONS .1 Depending on: ※ the stage of the disease ※ the mechanism of myocardial damage ※ the specific etiological agent ※ differing genetic susceptibility of patients CLINICAL MANIFESTATIONS .2 asymptomatic symptomatic CLINICAL MANIFESTATIONS .3 asymptomatic complete recovery unrecognized arrhy