Myocardial dystrophy

Myocardial dystrophy is a noninflammatory lesion of the cardiac muscle as a result of disturbances in its metabolism under the influence of non-cardiac factors.

Etiology. Acute and chronic exogenous intoxications, including alcoholic (see), endocrine and metabolic disorders (thyrotoxicosis, myxedema, Cushing's syndrome, obesity, diabetes mellitus, vitamin deficiency, starvation), anemia, pathological menopause, physical overstrain ("soldier's heart") , Infection (including tonsillar), physical agents (radiation, weightlessness, overheating), systemic diseases (collagenoses, neuromuscular dystrophy, etc.). Myocardial dystrophy is also associated with the deposition in the myocardium of metabolic pathogens or normal metabolites: amyloid, iron (with hemochromatosis), glycogen, etc. Some forms of myocardial dystrophy are also often called myocardiopathies (alcoholic, menopausal, amyloid).

Pathogenesis. Change in the course of biochemical processes in the myocardium with subsequent disruption of microstructures and contractile function of muscle fibers. These changes of the predefined limit are reversible.

Symptoms are often masked by signs of the underlying disease. There is increased fatigue, a slight shortness of breath with physical strains, a muffling of the heart's tone at the top, sometimes a mild tachycardia. In anemia, systolic murmur over the apex and pulmonary artery is often heard, with thyrotoxicosis pain in the heart area, pronounced tachycardia, increased systolic and pulse pressure, atrial fibrillation; With myxedema-shortness of breath, a rare pulse, hypotension, deafness of the heart tones, early signs of heart failure appear. With progressing myocardial dystrophy of any etiology, heart failure develops, cardiac rhythm disturbances occur. ECG changes are more often mild, expressed in a decrease, flattening or inversion of the T wave; With miksedem - a decrease in voltage; With electrolyte disturbances, changes observed with hypo- and hyperkalemia, hypomagnesemia, etc. Differential diagnosis is carried out with chronic ischemic heart disease, myocarditis, cardiomyopathy.

Treatment. Elimination of the main pathological process that caused myocardial dystrophy. Regulation of the regime of work, prevention of exercise, rational nutrition (correction of metabolic disorders), sanation of chronic foci of infection. Assign funds that facilitate the normalization of metabolism in the myocardium - multivitamin preparations, potassium orotate (1 g per day), cocarboxylase (50-100 mg per day), methandrostenolone, nerobol (0.005-0.01 g per day), etc.

The prognosis with adequate therapy is favorable.