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MYOCARDIODYSTROPHY

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MYOCARDIODYSTROPHY - non-inflammatory myocardial damage, characterized by dystrophy of contractile cells of the heart muscle, structures of the cardiac conduction system and manifested by symptoms of a violation of the basic functions of the heart (automatism, contractility, conduction, excitability).

The causes of myocardial dystrophy are the effects of bacterial toxins (for example, with chronic tonsillitis), industrial poisons (for example, leaded gasoline) and a number of chemicals used in everyday life, ionizing radiation; an overdose of certain medications (quinine, alupent, asthma, etc.); chronic alcoholism ; long-term deficiency in the diet of a number of substances necessary for the body (proteins, vitamins). An excess or deficiency of any biologically active substances is the basis of myocardial dystrophy, which develops in many noncommunicable diseases. The so-called thyrotoxic heart is a consequence of severe myocardial dystrophy, which occurs under the influence of an excess of thyroid hormones in the blood, and myocardial dystrophy in hypothyroidism is caused by a lack of these hormones. Hormonal myocardial dystrophy also occurs with pathological menopause. Myocardial dystrophy can be a consequence of myocardial overload (with arterial hypertension, heart defects, as a result of physical overstrain in athletes, etc.), especially if overload is combined with hypoxia; hypoxia also explains the development of myocardial dystrophy in severe anemia. After eliminating the causative factor, the trophic effect of the affected cardiomyocytes can fully recover, but if it acts for a long time, part of these cells die and are replaced by connective tissue, i.e., cardiosclerosis is formed.

Clinically, myocardial dystrophy is manifested by symptoms of impaired myocardial contractility (shortness of breath, tachycardia , more often moderate and occurring only during physical exertion), automatism, conduction and excitability of the heart, which is reflected in various cardiac arrhythmias and conduction disturbances (extrasystole is especially often detected) detected on an ECG or auscultatory. Often, systolic murmur is heard in patients on the base or in the region of the apex of the heart, sometimes a muffled I tone; An ECG often has a reduced tooth voltage. In severe myocardial dystrophies, for example, with a thyrotoxic heart, chronic alcoholism, heart failure is more pronounced, especially if atrial fibrillation develops, shortness of breath and tachycardia are observed at rest, the liver is enlarged, and swelling appears. In such cases, there is a need for differential diagnosis with myocarditis, coronary heart disease, which, as a rule, is only possible when examining a patient in a specialized cardiology department.

Prevention and treatment are reduced primarily to the elimination of the causative factor. In all cases, they recommend the appointment of a complete diet rich in proteins, use multivitamins, potassium orotate, riboxin , and sometimes anabolic hormones (methandrostenediol, nerobol, retabolil). If necessary, treat heart failure and arrhythmias.