VIRUSNI MIOKARDITIS - DIJAGNOSTIČKI I TERAPIJSKI IZAZOV ZA LEKARE
Journal Title: Acta Facultatis Medicae Naissensis - Year 2012, Vol 29, Issue 2
Abstract
Miokarditis se definiše kao zapaljenje srčanog mišića prema kliničkim, imunohistohemijskim i patološkim kriterijumima. Miokarditis se može manifestovati širokim spektrom simptoma od blage dispneje do bola u grudima, a ponekad bez specifične terapije može dovesti do kardiogenog šoka i smrti. Prema podacima, učestalost miokarditisa je 8-10 slučajeva na 100000, a prevalenca na neselektovanim obdukcijama je 1-5 na 100 slučajeva. Najčešći mogući izazivači miokarditisa: koksaki virus B3, parvovirus B19, adenovirusi i humani herpesvirus 6. Patogeneza virusnog miokarditisa prolazi kroz tri faze: akutne virusne infekcije, infiltracije zapaljenskim ćelijama i remodelovanja miokarda. Početna evaluacija bolesnika obuhvata detaljnu istoriju bolesti i pažljiv fizički pregled; u daljem toku treba uraditi elektrokardiogram, rentgen srca i pluća, analize krvi, neinvazivne metode snimanja srca. Dijagnoza miokarditisa može se postaviti samo endomiokardnom biopsijom, uključujući: histologiju, immunohistologiju i molekularnu biologiju ili virusologiju. Terapija se može podeliti na suporativnu i specifičnu terapiju (imunosupresivna terapija, interferon, imunoglobulini, imuno adsorptivna terapija, imuno-modulacija, vakcinacija).
Authors and Affiliations
Dejan Simonović, Marina Deljanin Ilić
Keywords
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