“Cold” after three or four days, symptoms worsen, beware of fulminant myocarditis
By Zhang Hua of jinyang.com
Fever, cough, dizziness, fatigue and chest tightness caused by cold usually recover in a week. However, the mortality of fulminant myocarditis is as high as 55%. Cardiology experts remind young people that after three or four days of catching a cold, their symptoms continue to worsen, especially fatigue, chest tightness and lack of appetite. Don’t insist on going to work or running, or they may lose their lives.
The population under 40 years old is a high risk population of fulminant myocarditis,
What is fulminant myocarditis? Wang Daowen, director of Cardiology Department of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology, introduced at the Guangdong heart failure prevention and treatment forum and fulminant myocarditis diagnosis and treatment promotion class (Guangzhou station). This is an extremely dangerous cardiovascular emergency with the characteristics of sudden onset. After infection with the virus, the patient suffered from myocardial damage and soon developed heart failure or heart failure Severe arrhythmia, accompanied by lung, liver, kidney and other organ failure, the mortality rate is as high as 55%.
According to the survey data of heart disease in 2015, the number of sudden cardiac death in China is 41.9 per 100000 people. People in the workplace often suffer from the decline of their own immunity due to long-term overwork, excessive exercise and excessive weight loss. Young people under the age of 40 are the high incidence of fulminant myocarditis, accounting for about 70% of the sudden cardiac death, and there is an increasing trend. Compared with the elderly and children, the self immunity of young people is stronger. When they are invaded by the virus, their own defense system not only removes the virus, but also damages their own myocardial cells.
“The symptoms of this disease are very similar to those of a cold, because people don’t pay enough attention to it.” Wang Daowen said, “many cases of sudden death caused by strenuous exercise after a cold are likely to be fulminant myocarditis. In addition, nearly 50% of deaths due to influenza are due to fulminant myocarditis (the other half is severe pneumonia).
Diagnosis should be differentiated from myocardial infarction
Different from cold symptoms, the symptoms of shortness of breath, dyspnea, chest tightness, chest pain, extreme fatigue, chest tightness, shortness of breath and loss of appetite are more prominent in patients with fulminant myocarditis 1-3 weeks after infection. Wang Daowen stressed that when patients have these symptoms, we must be vigilant.
According to the statistics of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology, about 90% of patients with fulminant myocarditis were treated or referred because of dyspnea, and 10% of patients were treated or referred because of syncope or after cardiopulmonary resuscitation.
It is worth noting that many people are misdiagnosed as “myocardial infarction” because of shortness of breath, chest tightness and chest pain. Therefore, Wang Daowen stressed that in clinic, fulminant myocarditis should be differentiated from myocardial infarction. Generally speaking, when the onset of sudden, there are obvious symptoms of viral infection, such as general fatigue, do not want to eat and quickly appear a serious increase in troponin, brain natriuretic peptide significantly increased, ECG sinus tachycardia, ultrasonic electrocardiogram diffuse wall motion weakened, should be more considered for fulminant myocarditis. Of course, it can also be identified by coronary angiography.
Based on life support,
The success rate of comprehensive treatment was as high as 95%
In the past, many doctors on fulminant myocarditis can only let fate, treatment effect is not good. However, the “comprehensive treatment plan based on life support” summarized by Wang Daowen’s team has increased the success rate of treatment to more than 95% and reduced the mortality rate to less than 5%. At present, Tongji Hospital has received more than 50 cases of fulminant myocarditis patients in the past two years, no one died.
Just a while ago, a 27 year old rural mother developed symptoms of hypotension and coma five or six days after “catching a cold”. The local hospital thought that her condition had worsened and referred her to Tongji Hospital. After removing myocardial infarction in Tongji Hospital, he was diagnosed with fulminant myocarditis. Director Wang Daowen immediately started intra aortic balloon counterpulsation (IABP), ventilator and artificial lung to reduce the patient’s heart load and allow the injured heart time to recover. At the same time, antiviral and antibacterial treatment, active supplement of water-soluble and fat soluble vitamins, and even a large dose of glucocorticoid anti-inflammatory, anti shock. During the treatment, the patients were absolutely bed rest, light diet, ECG and hemodynamic monitoring, blood oxygen monitoring and ultrasound follow-up.
14 days later, the mother of two miraculously recovered and discharged. Wang Daowen said that successful patients treated in this way rarely have heart sequelae and the recurrence rate is extremely low. Therefore, the significance of successful treatment is extremely important. It is understood that this set of treatment methods has been compiled as the first “expert consensus on diagnosis and treatment of adult fulminant myocarditis (2017)” in China. Wang Daowen said that the consensus can provide effective and standard treatment guidance for doctors, improve the success rate of treatment, and save more young patients’ lives.
Finally, experts also remind the public that early treatment is the key to reversing fulminant myocarditis. Once the “cold” symptoms, combined with obvious fatigue, shortness of breath, chest tightness and other symptoms, should immediately see a doctor, must not delay the disease.