Myocardiodystrophy

Myocardial (synonym degeneration of myocardium) - damage to the heart muscle, connected with infringement of metabolism. Myocardial occurs when insufficient supply of gaseous oxygen, prolonged fatigue heart muscle, if vitamin a deficiency, disorders of protein, carbohydrate and electrolyte metabolism, endocrine disorders and intoxication. It occurs when the coronary atherosclerosis, heart disease, anemia, liver failure, uremia, diabetes, thyrotoxicosis and other Clinical picture of cardiomyopathy has no specific symptoms. Complaints may be missing; sometimes there shortness of breath, palpitations. During the inspection may show the expansion of the boundaries of the heart, weakening of the first tone at the top, disorder of heart rhythm. On the ECG are changing, typical diffuse myocardial damage. Severe myocardial may be accompanied by severe circulatory insufficiency. Changes in the heart muscle during an early start in the treatment of reversible.
The treatment should be aimed at eliminating the cause of myocardial, and to improve metabolic processes in myocardium. Assign intravenous glucose 20 ml of 40% solution with sodium ascorbate 1 to 5 ml of 5% solution for 15 to 20 days; b vitamins intramuscularly: thiamine-bromide (B1) and 1 ml 6% solution every day for 20-30 days; B6 1 ml of 2.5% solution every day for 20-25 days and others also Used kocarboksilazu (instead of vitamin B1) intramuscularly in a dose of 100 to 200 mg daily for 15-30 days or ATF (1 ml of 1% solution disodium salt adenosine triphosphate intramuscularly daily for 30-40 days).

Myocardiodystrophy [myocardiodystrophia; from the Greek. mys, myos - muscle, kardia - heart+dystrophy; synonym degeneration of myocardium (dystrophia myocardii); close cousins - micardis, miocarde] - functional-clinical concept that refers to pathological changes in the biochemical and physical-chemical structure of the myocardium (G. F. lang). The term myocardial" unites all non-inflammatory lesions attack occurring at the molecular and cellular levels, in the final stages of which are developing visible morphological changes, referred to as myode-generatio cordis.
The muscle of the heart is the organ that converts chemical energy into mechanical energy. Myocardial causes changes bioenergetic processes and expressed violations of contractile and other features of infarction. Improvements histochemical, gestatsionnogo and electron microscopic investigation methods can significantly more frequently to detect changes in the structure of myocardium in different forms and degrees of cardiomyopathy. Schematically, you can imagine the development of cardiomyopathy as a result of violation of action or lack of each component of muscle metabolism, resulting we will experience a disorder of education of chemical energy, or under its transformation into mechanical, or both. The most common and obvious reason of breach of energy is the oxygen deficiency (anaemia, asphyxia, coronary insufficiency, etc) or relative hypoxia under overload infarction (heart disease, hypertension, hyperthyroidism and so on). Less frequent reason is lack of enzymes, vitamins (such as beriberi) or a lack of energy substances. Insufficient use of energy can come at protein changes of the myocardium (dysproteinemia, hemochromatosis), ionic composition of blood, especially potassium, lesion, muscle membranes (infection, intoxication, disorders of innervation). The problem of studying of metabolism in the myocardium in norm and pathology appeared in Russian medicine long before research of foreign scientists. The opening of I. P. Pavlov in 1882 reinforcing nerve heart started studying the influence of the nervous system on the metabolism and the trophic state of the heart muscle.
Symptoms of cardiomyopathy usually are only part of the clinical picture of the underlying disease. Typical for most cases of cardiomyopathy are: 1) reversibility of infringements of a metabolism in the myocardium (if timely treatment); 2) ECG changes, reflecting the initial manifestations of the involvement of the heart in misery; expressed as cardiac weakness, congestion, etc., are developing relatively rare and, in the final stage; 3) resistance is encountered failure of the myocardium to the therapeutic effects of digitalis preparations or strofantina.
Depending on the etiology of cardiomyopathy pathogenesis, clinic and treatment of its different. Therefore it is expedient all kinds of myocardial degeneration be divided into several groups. Degeneration of myocardium in case of: 1) anemia, 2) starvation, 3) violations of certain types of metabolism, 4) vitamin a deficiency, 5) hormonal disorders, 6) the liver and kidneys, 7) intoxication.
Symptoms of cardiomyopathy usually takes a modest position in the clinical picture of the underlying disease, for recognition of the status of a myocardium, a careful assessment. A General breakdown of metabolism in the patient, caused by defeat of the liver, kidneys, endocrine glands, etc., suggests the change of a metabolism in the myocardium. In the initial period M subjective symptoms almost always absent, and significant fatigue when voltage is often attributed to other causes.
Careful listening to the heart allows, with rare exceptions (for example, thyroid heart), discover the weakening of sonority first tone; to diagnose especially probative reduce its sonority repeated researches. Gallop rhythm, usually prettiesiski, confirms the diagnosis of functional insufficiency of the myocardium. No less valuable for diagnostic appearance of adults, as well as changing the frequency of cardiac contractions.
Often crucial for the evaluation of myocardium is instrumental investigation: phonocardiography (see Ponografia) detects the changes in the duration of mechanical systole, the emergence galapago tone; electrotomography opens features ripple different parts of the heart, and the contractile ability of the heart, identified in the analysis phase of myocardial systolic (the duration of the voltage of the period of exile and their ratio); electrocardiography (see) and often quite early detect deviations from the norm. X-ray examination, detecting changes in the magnitude of the heart (myopathy configuration), shows far comes myocardial damage. Heart failure when myocardial degeneration in the beginning may not be accompanied by signs of stagnation, the latter usually appear in the final period. In all cases of chronic circulatory failure, not amenable to conventional treatment of cardiac and diuretics (the so-called refractory form), you should assume a profound degeneration of myocardium.

Myocardial at: