Myocardial dystrophy of complex genesis treatment

Currently, many people suffer from myocardial dystrophy disease. Not everyone knows what it is and how to treat it. Myocardial dystrophy (abbreviated as MKD) includes a group of heart diseases that are non-inflammatory in nature. With the disease, there is a decrease in the contractile function of the heart, its excitability, conductivity, automatism and a violation of the myocardial metabolic processes.

Myocardial dystrophy of the heart muscle occurs due to strong loads on the heart during improper and intensive training. Also, an unbalanced diet, a short rest, constant interruption of sleep can provoke the appearance of MCD. Other common factors for the development of myocardial dystrophy include:

  • infectious diseases in the phase of inflammation;
  • chronic tonsillitis;
  • intoxication of the body (poisoning, alcohol, cigarettes, drugs);
  • overweight;
  • myxedema;
  • avitaminosis;
  • diabetes;
  • thyrotoxicosis;
  • anemia;
  • radiation;
  • muscular dystrophy;
  • genital inflammation;
  • collagenosis;
  • the appearance of menopause in women;
  • overheating;
  • lack of potassium in the body;
  • Cushing’s syndrome;
  • starvation;
  • prolonged stay on mono-diets;
  • deposition of salts in the heart muscle.

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Symptoms of MCD

Signs of myocardial dystrophy are most often seen only with intense physical exertion. At rest, the disease is passive. Symptoms of MKD can often be confused with other diseases, so myocardial dystrophy is quite difficult to identify and diagnose at the primary stage. The main signs of MKD disease:

  • spasmodic or aching chest pain;
  • fatigue;
  • impotence;
  • state of depression;
  • shortness of breath when moving;
  • weakness;
  • cardiopalmus ;
  • pain in the heart;
  • interruption of the heart muscle;
  • arrhythmia;
  • systolic murmur at the apex of the heart;
  • slow heart rate.

In chronic cases, myocardial dystrophy of the heart, treatment, symptoms – all this takes on a complex character. The patient has severe shortness of breath at rest, enlarged liver, and the appearance of edema.

MKD treatment

In myocardial dystrophy, symptoms, causes and treatment play a leading role. It is important to consult a doctor when the first signs appear. In this case, there is a chance for a speedy recovery.

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A cardiologist will be able to solve a number of problems:

  • identify the cause of the disease;
  • timely diagnose;
  • prescribe adequate therapy.

This kind of treatment should be carried out in a hospital under the supervision of medical specialists.

When applying for help, a cardiologist will first of all take readings on an electrocardiogram (ECG), make an ultrasound of the heart and give advice on correcting the usual way of life. Be sure to introduce a balanced diet to restore normal metabolism, and also excludes any physical work. As a rule, with a disease of myocardial dystrophy, bed rest is not recommended.

Next, the doctor conducts a study of tests to identify infectious foci that caused myocardial dystrophy. If any are found, their reorganization is carried out.

Drug therapy is also indicated. Very often, doctors prescribe pills that restore metabolism in the myocardium: Mexicor and Trimetazidine. They have antihypoxic and cytoprotective effects. The drugs are prescribed in a course dose of up to two months, 1 tablet 3 times a day.

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To normalize the ECG and increase the level of potassium in the body, take Asparkam or Panangin, 1 tablet 3 times a day.

To calm the nervous system, antipsychotics and tranquilizers are sometimes prescribed, for example, Sonopax, Coaxil.

It is important to know that any drugs immediately before their use should be agreed with your doctor. It is necessary to strictly observe the recommended dosage and the rules for taking tablets.

Classification of MKD

Classification of the disease myocardial dystrophy – what is it? These are actually species according to the etiological characteristics of the disease myocardial dystrophy. Classification is represented by the following forms of MKD:

  • allergic
  • mixed genesis;
  • complex genesis;
  • hyperfunctional;
  • neurovegetative;
  • hormonal (endocrine diseases and age-related dishormonosis);
  • hereditary diseases;
  • dysmetabolic (anemia, dystrophy, vitamin deficiency);
  • intoxication (poisoning, infectious diseases, alcohol, smoking, drug addiction).
  • alimentary;
  • radiation;
  • closed chest injuries.

Dyshormonal MCD

Dyshormonal myocardial dystrophy – what is it?

Dyshormonal myocardial dystrophy is a heart disease caused by a dysfunction of the thyroid gland. During hypothyroidism (decreased function), the body’s metabolism slows down, pressure decreases, edema and prolonged aching pain appear. With thyrotoxicosis (increased thyroid function), metabolism is accelerated and contributes to rapid weight loss. Also, the patient feels stitching heart pains, thirst, excessive nervousness; disturbed heart rate and sleep.

Symptoms of dishormonal MKD are:

  • dizziness;
  • lack of air;
  • disturbed sleep;
  • stitching pains in the heart;
  • irritability and more.

As a rule, such myocardial dystrophy appears in women from 45 to 50 years old, since at this age the ovarian function malfunctions. Men aged 50-55 are also susceptible to this disease due to impaired testosterone production.

Treatment

With the disease, dyshormonal myocardial dystrophy, treatment is prescribed in the form of specific tips and recommendations for maintaining a healthy lifestyle. One of the important roles here is mobility:

  • relaxation;
  • therapeutic exercises (6-7 minutes per day);
  • swimming and other sports that do not require a heavy load.

Every morning you need to take a contrast shower for 10 minutes. It is necessary to observe a diet, exclude flour, smoked and fatty foods.

If the methods of maintaining a healthy lifestyle do not bring proper results, doctors will switch to drug therapy: Belloid, Valerian, Bellataminal. If you want to reduce the excitability of the nervous system, then prescribe tranquilizers, for example, “Mebicar”. This drug does not cause drowsiness, does not affect the reduction in working capacity and does not interfere with the coordination of movements. The daily dose reaches three tablets. If Mebikar is ineffective, it is replaced with another drug.

Myocardial dystrophy of mixed origin has a negative effect on the heart muscle, deforming it over time. As a result of this, stretching of the ventricular tissue occurs, flabbiness and thinning of the septum appear.

Symptoms

Signs of a manifestation of the disease myocardial dystrophy of mixed origin are “masked” by the disease myocardial dystrophy itself. Symptoms and treatment in this case are very similar:

  • shortness of breath during exercise;
  • high fatigue;
  • tachycardia;
  • impotence;
  • intermittent pulse work.

With the rapid development of the disease, a person has malfunctions and heart rhythm disturbances, as well as heart failure.

Treatment

Therapy of myocardial dystrophy of mixed genesis requires increased attention from doctors, since the patient’s life will depend on the outcome of its treatment.

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Modern scientists in the field of medicine claim that the most effective and correct method of treating the disease today is the use of stem cells. They are introduced into the patient’s body, they join healthy heart cells. Cardiac muscle recovery occurs by expelling diseased cells to healthy ones.

MCD complex genesis

Myocardial dystrophy of complex origin is one of the varieties of the common disease myocardial dystrophy. What is it and what are the causes of its occurrence? The disease affects the heart muscle and is non-inflammatory. Factors affecting the formation of MCD of complex origin are not associated with heart disease:

  • intoxication of the body (poisoning, alcohol, drugs, cigarettes);
  • violation of the functions of the endocrine system;
  • metabolic failure.

Such myocardial dystrophy (its symptoms and treatment, in principle, are very similar to any other heart diseases) is manifested in tachycardia, shortness of breath, heart failure, chest pain, fatigue, chills.

When treating, first of all, they eliminate the reason why the MCD of complex genesis was caused. Doctors prescribe various kinds of medications: Potassium Orotate, Nerobol, Cardiomagnyl, and others. Such drugs restore myocardial metabolism.

However, without observing the correct daily routine and nutrition, the tablets will be ineffective, so you should adhere to a healthy and active lifestyle.

Approaching the treatment of the disease in a comprehensive manner, we can count on a speedy recovery and improvement in the general condition.

Secondary MCD

MCD itself is a secondary heart disease. Therefore, secondary myocardial dystrophy has no predominant differences in its manifestation and treatment. The main symptoms are added only pain in the heart and chest, as well as arrhythmia. This form of the disease most often develops in women during menopause, when the ovaries are disrupted.

Very often, children and adolescents are prone to MKD. This is often due to several factors:

  • mental and emotional stress of children;
  • irrational physical stress;
  • malnutrition;
  • lack of protein in the body;
  • improper child care;
  • infectious diseases in an advanced stage.

Myocardial dystrophy in children is not very pronounced and is asymptomatic, therefore, with any suspicion of heart problems, you should immediately consult a cardiologist.

If this disease has a place to be, then it is better to cure it in childhood, in order to eliminate the risk of further development of MCD and its detrimental effect on the children’s body.

Diagnostics

Detection of myocardial dystrophy in children, as in adults, is carried out by standard measures: ultrasound of the heart, ECG and examination by a cardiologist, after which a final diagnosis is made.

The duration and effectiveness of treatment with MKD in children depends on the pathology of the development of the disease, which provoked myocardial dystrophy. Most often, children are prescribed potassium and magnesium salt preparations. These drugs restore metabolic processes in the myocardium, normalize the ECG, eliminate electrolyte cellular disorders, replenish the body with potassium and magnesium.

Compatibility of the concepts of myocardial dystrophy and cardiomyopathy

Currently, in addition to the term myocardial dystrophy, another concept is often used – cardiomyopathy. After reading the academic definitions of what is meant by cardiomyopathy and myocardial dystrophy, one might get the impression that these terms reflect the same pathological conditions of the heart. However, this is not true.

Firstly, historically, the term myocardial dystrophy, introduced in 1936, is used in the former USSR and the present CIS. And in the countries of Europe and the USA, they use the term cardiomyopathy, introduced in 1957. At first glance, the terms are very similar, on the basis of which many believe that cardiomyopathy and myocardial dystrophy are synonyms and mean the same pathological conditions. But with a more detailed analysis, it turns out that this is not entirely true.

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The composition of cardiomyopathies includes a wider range of various disorders of the heart, not associated with diseases of the cardiovascular system. That is, the main characterological sign of cardiomyopathies, on the basis of which this or that condition is attributed to this variety of heart disease, is that they are provoked not by cardiovascular diseases or by completely unknown reasons.

That is, common to the concepts of myocardial dystrophy and cardiomyopathy is that both groups of diseases include disorders of the heart muscle, provoked not by cardiovascular diseases, but by pathologies of other organs and systems. In addition, there are primary cardiomyopathies that occur for unknown reasons against the background of the absence of any diseases of other organs and systems.

But the group of myocardial dystrophies includes only those of cardiomyopathies that are characterized by metabolic disorders in the cells of the heart muscle and are provoked by some disease of another organ or system. Thus, it is obvious that cardiomyopathy is a much wider group of pathological conditions compared with myocardial dystrophy.

That is why at present, doctors and scientists believe that the terms myocardial dystrophy and cardiomyopathy are not completely identical to each other and therefore cannot be used as synonyms. According to the recommendations of leading scientists, the term myocardial dystrophy corresponds to only one type of cardiomyopathy, namely cardiomyopathy in metabolic disorders and eating disorders. This is exactly what the disease is called according to ICD-10 (International Classification of Diseases 10 revision). Read more about cardiomyopathy.

Symptoms

  • spasmodic or aching chest pain;
  • fatigue;
  • impotence;
  • state of depression;
  • shortness of breath when moving;
  • weakness;
  • cardiopalmus ;
  • pain in the heart;
  • interruption of the heart muscle;
  • arrhythmia;
  • systolic murmur at the apex of the heart;
  • slow heart rate.

In chronic cases, myocardial dystrophy of the heart, treatment, symptoms – all this takes on a complex character. The patient has severe shortness of breath at rest, enlarged liver, and the appearance of edema.

Symptoms such as shortness of breath, palpitations even at rest, and fatigue develop gradually. There is no pain in the region of the heart, but many patients report some discomfort.

With the development of pathology, the symptoms intensify. Coughing is associated with shortness of breath and tachycardia, especially at night.

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Dystrophic changes in the heart muscle occur in three stages:

  1. Myocardium wears out. The patient develops symptoms such as heart pain and heavy breath. The level of physical endurance is significantly reduced. You can’t see the changes on the electrocardiogram.
  2. The initial stage of deterioration of contractile function. Symptoms such as arrhythmia, swelling of the extremities, shortness of breath occur. The cardiogram shows minor changes.
  3. The contractile function is greatly reduced. The tone of the heart muscles decreases. The patient is accompanied by symptoms such as swelling, constant pain in the heart, shortness of breath, fatigue. All changes are clearly visible on the ECG.
  • high fatigue;
  • tachycardia;
  • impotence;
  • intermittent pulse work.

    Myocardial dystrophy develops in stages. Each stage of the process has its own symptoms corresponding to the degree of violation of biochemical processes in the tissues of the heart. In addition to these manifestations, patients have complaints inherent in the underlying disease – the cause of myocardial damage.

    • Irregular, indistinct, weak pain in the projection of the heart. They arise against the background of emotional or physical stress. At rest, there is no pain.
    • Moderate fatigue after the usual stress.
    • Slight weight loss may be noted.
    • Patients feel satisfactory, can do the usual things.
    • There are no changes in the study of myocardial function.
    • Dyspnea, sharply worse lying down. In the extreme stage, patients can only sleep lying down.
    • Severe weakness, progressive fatigue from any work.
    • Inability to perform familiar activities and physical activity.
    • Weight loss.
    • Palpitations.
    • Violation of the rhythm of myocardial contractions.
    • Swelling of the feet and legs.
    • Wet wheezing in the lungs when breathing.
    • Significant changes in research.

    As a rule, the entire clinical picture in the early stages of the disease is not concentrated around the changes occurring in the heart, but is due to the underlying disease. Since the causes of the disease are diverse, the symptom complex is also uneven and completely nonspecific. Usually, at the initial stage of the disease, pathological signs are completely absent, or increased fatigue and fatigue appear. Some people may experience increased heart rate, shortness of breath during physical exertion.

    Subsequently, with the progression of myocardial dystrophy, the functions of a part of the heart or the entire organ are violated, and it is the severity and localization of these disorders that determines the existing symptoms and complications. The clinical picture may include such components:

    • different types of arrhythmias;
    • complete or incomplete heart block;
    • changes in heart rhythms diagnosed by ECG;
    • pain in the heart – cardialgia.

    As a rule, signs of functional heart failure appear in the later stages, but with intoxication with cardiac glycosides, poisons, severe overstrain, they are able to develop at the very beginning of the disease. There are some distinctive symptoms with various forms of myocardial dystrophy. So, with vitamin deficiency and lack of protein, pallor, a decrease in body temperature, dizziness, cold feet and hands, fainting, high fatigue, muscle weakness appear early.

    With anemia and tissue hypoxia, myocardial dystrophy is manifested by tachycardia, a feeling of a strong heartbeat, pulsation of the carotid arteries, shortness of breath, and pallor of a person. Due to left ventricular hypertrophy, the heart expands to the left, so a characteristic systolic murmur appears. With alcoholic MKD, there is tachycardia and extrasystole, shortness of breath during physical exertion, cardiomegaly, and later – complex rhythm and cardiac conduction disturbances. At an early stage, atrial fibrillation and congestive heart failure can occur, which is very dangerous for the development of ventricular fibrillation.

    With thyrotoxicosis, an increase in temperature, an increase in pressure and pulse, increased pulsation of large arteries, shortness of breath on exertion, stitching pains in the heart, and a feeling of interruptions in its work come to the fore. The tolerance of physical exertion is greatly reduced, in the absence of treatment, severe types of arrhythmia occur, the patient may be assigned disability due to pulmonary hypertension and chronic congestive processes in the lungs and a high risk of sudden death.

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    With MCD, against the background of electrolyte imbalance, renal failure occurs, accompanied by edema and pain. Long-term diarrhea, muscle weakness, a sharp decrease in performance can also be diagnosed. Thus, the prognosis for MKD largely depends on the cause of the pathology and the speed of its correction or its complete elimination: with the late start of therapy, the development of irreversible changes and even death can occur.

    All clinical manifestations of myocardial dystrophy are based on cardiodynamic disturbances caused by a moderate or pronounced decrease in cardiac contractile function. The most characteristic complaints of a patient suffering from myocardial dystrophy are a feeling of aching pain in the projection of the location of the heart, a sense of discomfort and interruptions in the rhythm of cardiac activity, which are short-term in nature and are not accompanied by a significant disability of a person.

    In a situation where myocardial dystrophy is accompanied by the development of degenerative changes in the myocardium and the appearance of signs of congestive heart failure, the patient has pathognomonic symptoms in the form of severe edematous syndrome of both peripheral and central types, progressive respiratory disorders and cardiac arrhythmias in the form of extrasystole, tachycardia and paroxysmal atrial fibrillation.

    Myocardial dystrophy in children has some features of the course, manifested by a long latent period, during which the child absolutely does not have any clinical manifestations. This period is dangerous because without the use of routine diagnostic methods, early verification of the diagnosis is much more difficult and there is a high risk of developing cardiovascular complications amid complete well-being.

    Tonsillogenous myocardial dystrophy is characterized in that the development of clinical signs occurs several days after the transfer of angina and manifests itself in the form of the appearance of intense pain in the heart, progressive weakness, interruptions in the work of the heart, low-grade fever and arthralgia.

    With regard to diagnostic measures that can reliably verify the diagnosis, electrocardiography, echocardioscopy and phonocardiography are used. The main electrocardiographic criteria for myocardial dystrophy is the appearance of incorrect orientation and deformation of the T wave in several leads, a distorted U wave and a decrease in the ST segment by at least 1 mm.

    Myocardial dystrophy is characterized by more specific changes when performing echocardioscopy, since in this situation the patient shows signs of hemodynamic disturbances in the complete absence of organic myocardial damage. Changes in phonocardiography with myocardial dystrophy develop only at the stage of decompensation of cardiac activity and are manifested in the form of registration of the gallop rhythm and systolic murmur in the projection of the apex of the heart.

    Laboratory changes in myocardial dystrophy are detected only in the terminal stage and are manifested in the form of a decrease in the activity of mitochondria of cardiomyocytes. Identification of these changes reflects an extremely unfavorable course of myocardial dystrophy and is a negative prognostic sign.

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    In difficult diagnostic situations in which the patient has pronounced clinical manifestations and hemodynamic disturbances that do not correspond to the revealed changes in the myocardium, a puncture biopsy of the heart muscle is recommended. For this purpose, endomyocardial material is taken under local anesthesia. This technique is difficult to perform, so its practical application is minimal.

    In cardiological practice, specialists use the clinical classification of myocardial dystrophy, according to which it is customary to separate the three stages of development of this pathology. In the initial stage, there is a compensatory increase in the function of the heart muscle in response to dysmetabolic disorders occurring in the myocardium.

    Clinically, this condition is manifested by non-specific prolonged cardialgia and a slight decrease in the tolerance of physical activity. Instrumental imaging methods are not accompanied by the detection of pathological changes in the structures of the cardiovascular system. The stage of clinical compensation is characterized by the development of cardiodynamic and respiratory disorders.

    Fatigue is one of the earliest symptoms of myocardial dystrophy.

    Types of pathological changes

    1. Dysmetabolic myocardial dystrophy.
    2. Myocardial dystrophy of mixed origin.

    Dyshormonal myocardial dystrophy occurs as a result of hormonal disorders. Usually, the disease affects women during menopause and men with a disorder in testosterone production.

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    This type of disease in women develops at an accelerated pace, therefore it is recommended that after 45 years pass preventive examinations in order to detect changes in the myocardium as soon as possible.

    This can happen if:

    • a person lacks vitamins, minerals;
    • disrupted protein metabolism in the tissues.

    A disease of mixed origin occurs as a result of the presence of low hemoglobin, vitamin deficiency, endocrine disorders, that is, the pathological process begins under the influence of several factors. Such diffuse-dystrophic changes lead to myocardial deformation, stretching of its cells and a decrease in the thickness of the septum.

    Diffuse-dystrophic changes of complex origin develop under the influence of external factors:

    • alcohol abuse;
    • smoking;
    • addiction;
    • endocrine and metabolic disorders;
    • body poisoning.

    Human heart
    – a hollow four-chamber organ that acts as a pump in the body. Its main function is to provide non-stop movement of blood throughout the body.

    The heart is located in the chest, mainly on the left side. It is divided by a septum into two halves, each of which consists of the atrium and ventricle. The right half of the heart pumps blood through the lungs (pulmonary circulation), and the left through the rest of the organs (pulmonary circulation).

    The shell of the heart.
    The heart wall consists of three layers:

    • Endocardium
      – the inner lining of the heart. Its basis is the special cells of the connective tissue that line the inner surface of the heart. Their function is to ensure smooth gliding of blood and to prevent the attachment of blood clots.
    • Myocardium
      – the middle membrane of the heart. It consists of special muscle cells (cardiomyocytes) and provides heart contraction.
    • Epicardium
      – serous membrane of the heart, covering the myocardium from the outside. It provides movement of the heart in the pericardial sac.

    Pericardium or pericardial bag
    Is the outer lining of the heart. It is a cover made of connective tissue, separated from the epicardium by a slit filled with liquid. Its main task is not to allow the heart to stretch and protect it from friction against other organs.

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    Let us consider in more detail the composition and functions of the myocardium, since it is it that is affected by myocardial dystrophy.

    Myocardium
    – The muscle layer of the heart, which is a dense cluster of special muscle cells – cardiomyocytes. The myocardium of the atria and ventricles is functionally separated from each other. Due to this, the atria and ventricles contract not synchronously. In the atria, the muscle layer is 2 times thinner (2-3 mm), since these areas of the heart do less work. The thickness of the myocardium in the ventricles is 4-6 mm.

    The myocardium includes
    :

    • Muscle fibers
      striated muscle tissue, providing a contraction of the heart.
    • Fibers of the conduction system of the heart
      form nodes and conductive bundles. The nodes (sinus, atrioventricular) generate excitation pulses, and the beams conduct pulses to various parts of the myocardium.

    Thus, atria and ventricles are controlled, and the heart works in a coordinated manner and maintains the necessary rhythm.

    Myocardial function
    provide contractility, excitability, conduction and automatism of the heart.

    • Contractility
      – the ability of the myocardium to contract and provide blood movement.
    • Excitability
      – the ability to respond to external and internal irritations. In response, the heart muscle contracts.
    • Automatism
      – the ability to contract and relax automatically without external stimulation.
    • Conductivity
      – the ability to drive excitation along the fibers of the cardiac conduction system.

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    Heart rate mechanism
    . A heart cell (cardiomyocyte) consists of many thin fibers of myofibrils located in different directions. They are able to contract and stretch.

    When myocardial cells receive a nerve impulse, they simultaneously contract. At the same time, the walls of the heart are compressed, reducing the volume of its chambers, and the blood is pushed out. Thanks to the heart valve system, it moves in one direction. The atria contract first and pump blood into the ventricles. After that, the valve between the atrium and the ventricle closes and a powerful contraction of the ventricles occurs, during which the blood enters the arteries.

    In order for cardiomyocytes to contract, a number of conditions are necessary:

    • an increase in the concentration of potassium ions in the cytoplasm, which is possible with a normal electrolyte balance.
    • receiving a nerve impulse by a cell – during normal operation of the cardiac conduction system.
    • enough energy must be produced in the mitochondria of the cell to contract (in the form of ATP and creatine). For this, cells must receive normal nutrition, which is possible only with good coronary circulation.

    With myocardial dystrophy, the heart contraction mechanism is disturbed. The heart is not contracting at full strength, which leads to poor circulation in the body. As a result, all tissues and organs receive insufficient nutrients and oxygen.

    With myocardial dystrophy, metabolic disorders are always detected at the level of the whole organism, the concentration of electrolytes (sodium, potassium, chlorine,

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    and others) in the blood and the functioning of the enzyme systems of cells. Due to these disorders, myocardial cells and the conduction system of the heart undergo dystrophic changes, which causes

    • Contractility (the ability of the myocardium to contract by throwing blood into the aorta and pulmonary trunk);
    • Excitability (the ability to generate an electrical impulse that, when transmitted to myocardial cells, will cause their contraction);
    • Conductivity (the ability to conduct an electrical impulse from one source to all parts of the heart);
    • Automatism (the ability to autonomously generate electrical impulses, conduct them and ensure the regularity of heart contractions, regardless of the constantly changing parameters of other organs and systems).

    These changes in the properties of the heart muscle and, accordingly, myocardial dysfunction are characteristic of all types of myocardial dystrophies, regardless of their variety and cause.

    Violations of the basic properties of the heart muscle (contractility, excitability, conduction and automatism) during myocardial dystrophy are caused by the gradual development of organic changes in myocardial cells. These changes in the initial stages, as a rule, are not detected. However, in the future, with the progression of the disease, pathological changes in the myocardial cells accumulate, which allows them to be detected during microscopic examination of tissue samples obtained by biopsy.

    So, for myocardial dystrophy of any kind and regardless of the causative factor, the following changes in cells are characteristic:

    • Dystrophy of muscle fibers (fibers break, become short, etc.);
    • Myocytolysis (decomposition of muscle cells of the myocardium);
    • Eosinophilia of cardiomyocytes (a large number of eosinophils in myocardial tissue);
    • Hyperchromic nuclei (nuclear chromatin becomes very dark);
    • The increased diameter of muscle fibers;
    • Foci of accumulation of various cells between muscle fibers;
    • Fibrosis of the intercellular spaces separating muscle fibers;
    • Fatty degeneration (accumulation of fat by muscle fiber cells);
    • Foci of necrosis of muscle fibers of the myocardium.

    These changes can only be detected by microscopic examination of a heart biopsy, which is not always possible. Therefore, it is equally important to know the macroscopic changes that occur with the heart during myocardial dystrophy.

    So, with myocardial dystrophy, the following changes in the structure of the heart are noted:

    • Expansion of the cavities of the heart, due to which the organ seems larger than normal;
    • Deformation of the heart due to uneven expansion of its ventricles and atria, due to which the organ acquires a more rounded shape;
    • Myocardial thickening (hypertrophy), developing as an attempt to compensate for the weakness of contractions by increasing the number of heart muscles;
    • Flabbiness and swelling of the myocardium;
    • The yellowish striation of the papillary muscles and trabeculae, due to which the organ acquires a characteristic color, called the “tiger heart”;
    • Fat deposits in the epicardium (the lining of the heart, covering the myocardium from the inside);
    • Fibrosis and cardiosclerosis.

    These changes can be more or less pronounced at various stages, however, they are present with any type of myocardial dystrophy. Also, the severity of changes in the heart depends on the cause of myocardial dystrophy.

    Classification

    In cardiology, such a thing as etiology is common. It means the conditions and causes of the onset of the disease. Back in the sixties of the last century, the scientist G. Lang created a classification system for myocardial dystrophy. This pathology can be a secondary complication of disorders of endocrine or hormonal functions in the body.

    The disease is due to the presence of painful disorders in the process of hormone production. The disease occurs in women older than 45 years and in men older than 50 years. In men, dishormonal cardiodystrophy appears due to impaired testosterone formation, and in women, due to changes in ovarian estrogen production, which often occurs during menopause. In rare cases, the cause may be premenstrual conditions, pathological changes in the cycle or gynecological diseases.

    This pathogenetic form of myocardial dystrophy is an infrequent diagnosis among the classes of the disease. The basis of pathogenesis is the lack of useful nutrients entering the body.

    A dysmetabolic type of heart dystrophy appears in patients with diabetes mellitus or amyloidosis. With regard to symptoms, manifestations of uncharacteristic pain in the heart area come to the fore, the rhythm of the heartbeat is disturbed, weakness appears. This type of myocardial dystrophy is characterized by the rapid development of the disease, the symptoms of blood stagnation and insufficiency of cardiac function early develop.

    It is characterized by particularly difficult development. Its appearance is not due to specific heart diseases. The main factor provoking the development of symptoms of myocardial dystrophy is a systematic metabolic disorder in organs and cells, which may be accompanied by pathogenic changes that are not related to heart function.

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    The manifestations of the first symptoms of myocardial dystrophy of complex genesis are nonspecific. Therefore, in many cases, it is impossible to diagnose the disease in the early stages. When the stage of marked changes in myocardial dystrophy sets in, their signs can be masked by other cardiac diseases, for example: by high fatigue, hypertension, respiratory distress, cardialgia, and a change in the rhythm of the heart.

    Myocardial dystrophy of mixed genesis is susceptible to children who suffer from chronic anemia. In childhood, neuroendocrine cardiodystrophy and electrolyte metabolic disorders develop. This type of disease can appear in adults.

    Myocardial dystrophy in children is diagnosed using an ECG in the presence of a combination of several factors that form the conditions for dystrophic disturbance of the structure of the myocardium of the heart. The very first changes on the part of the heart muscle in case of a disease of mixed genesis is a violation of the function of contraction, especially for the left ventricle of the heart.

    If myocardial dystrophy in children is not subjected to timely and proper treatment, the disease will have a negative effect on the excitability, automatism and conduction functions of each heart department. A complication of this condition may be the development of acute cardiological hemodynamic pathological phenomena.

    It is believed that alcoholic myocardial dystrophy may develop due to daily alcohol consumption for ten years. But if there is a hereditary deficiency of certain enzymes responsible for the processing of ethanol, frequent stresses and infectious diseases of a viral nature occur, then alcoholic cardiac dystrophy can also appear within three years of taking small daily doses of alcohol. This disease is often found in male patients aged 25 to 55 years.

    This type of cardiac myocardial dystrophy can develop in people who have been treated with immunosuppressants, antibiotics, NSAIDs, NCOs, tranquilizers for a long time. Also, dystrophy of the heart can develop with intoxication with arsenic, chloroform, phosphorus substances, harmful gases, etc. With thyrotoxic myocardial dystrophy, treatment with tranquilizers and antibiotics is prescribed.

    This form of cardiac myocardial dystrophy is characterized by prolonged compressive pain in the left chest, which is accompanied by weakness of the extremities, fever, excessive sweating. Patients are concerned about weakness throughout the body, increased fatigue, a decrease in physical endurance, and pain in the head.

    Classification of myocardial dystrophy is based on its subdivision according to etiology. It includes such forms of the disease:

    1. Dyshormonal. It occurs against the background of a violation of hormone production, including menopause, diseases of the testicles, ovaries, adrenal glands, thyroid gland, etc.
    2. Dysmetabolic. It develops in case of failures in metabolic processes in the body with diabetes, vitamin deficiency, anemia, obesity, etc.
    3. Mixed or complex. It includes all other types of disorders, except for the two mentioned above, which led to pathological processes in the myocardium. These include sports overload, infections, poisoning, etc.
    4. Unspecified. The cause of this form of myocardial dystrophy cannot be found.

    Since the described classification is rather arbitrary and does not reflect the whole variety of occurring phenomena and their causes, more often in practice doctors use a more advanced differentiation of MCD (the causes of the disease are marked in brackets):

    1. alcoholic (abuse or overdose of alcoholic beverages);
    2. toxic (taking drugs, drugs, poisoning with poisons and other substances);
    3. tonsillogenic (the presence of chronic foci of infection in the ENT organs);
    4. thyrotoxic (hyperthyro >5a8f133a981485a8f133a98196 - Myocardial dystrophy of complex genesis treatment

    Myocardial dystrophy occurs due to multiple circumstances, therefore, the disease is classified according to several stages and specifics. There are only three stages:

    1. Compensatory. Dystrophic changes in the myocardium have no clear signs. There is a slight pain in the heart after exercise, a fast or slow heart rate, shortness of breath after exertion, legs may swell in the evening.
    2. Subcompensatory. Symptoms are more pronounced, pain is stronger. Blood circulation is disturbed, the heart is enlarged.
    3. Decompensatory, or irreversible. Vivid, painful symptoms appear even at rest. The heart is greatly enlarged, the liver is also significantly enlarged, congestion begins in the lungs.

    Classification

    The disease is classified by etiology, which is presented as follows:

    • dishormonal form: occurs against the background of an imbalance of hormones during menopause, thyroid diseases, diseases of the adrenal glands and female genital organs;
    • dysmetabolic form: imbalance in metabolic processes caused by diabetes, anemia, obesity;
    • myocardial dystrophy of mixed origin, this form occurs with all the factors already listed;
    • unspecified form if it is not possible to establish the cause;
    • anemic: when characteristic noise is detected;
    • alcoholic: in case of alcohol abuse;
    • narcotic;
    • congenital.

    All this is partly justified and understandable, but, nevertheless, it is necessary to know the exact causes of the pathology. This is especially important for doctors in collecting anamnesis in order to accurately establish the diagnosis and prescribe treatment of myocardial dystrophy at a qualified level.

    In the treatment of pathology, it is necessary to determine and eliminate the cause of its appearance. In most of these cases, therapy gives a positive result.

    Dyshormonal MCD

    Dyshormonal myocardial dystrophy – what is it?

    Dyshormonal myocardial dystrophy is a heart disease caused by a dysfunction of the thyroid gland. During hypothyroidism (decreased function), the body’s metabolism slows down, pressure decreases, edema and prolonged aching pain appear. With thyrotoxicosis (increased thyroid function), metabolism is accelerated and contributes to rapid weight loss. Also, the patient feels stitching heart pains, thirst, excessive nervousness; disturbed heart rate and sleep.

    Symptoms of myocardial dystrophy in children

    At first, the disease proceeds without any particular symptoms. Everything happens quite abruptly, so doctors call this a “pathological surge”. In an older child, such a disease occurs due to excessive activity, poisoning, endocrine and vegetative-vascular disorders. In order to timely identify pathology, parents should carefully monitor the condition of the child. The following phenomena should alert:

    • fatigue;
    • dyspnea;
    • pallor of the skin;
    • blue circles under the eyes;
    • profuse sweating.

    If any of the above occurs in the case of a child, then a visit to the doctor should not be postponed.

    Children’s myocardial dystrophy is dangerous because in the body there is an active formation and growth of all internal organs, changes occur that exert a load on the heart. Violation of blood flow and additional load on the heart of the child threatens with serious physical abnormalities. Timely medical help can stop the pathological process. Otherwise, these are various heart diseases, underdevelopment, inferiority, and even death.

    Diagnostics

    5a8f133a9e3e95a8f133a9e465 - Myocardial dystrophy of complex genesis treatment

    To diagnose cardiomyodystrophy, electrocardiography (ECG) and Echo-KG are used.

    On the ECG, the doctor will detect irregular heart rhythm, impaired myocardial contractions, weak or insufficient contraction of the walls of the heart ventricles, changes in conduction in the heart. All of the above pathological processes indicate the presence of disorders of the cells of the contractile myocardium.

    On the echo-cardiogram, violations of the size of the heart cavities, their activity and contractile function are detected. This helps to identify the symptoms and treatment of dystrophic heart muscle disease.

    • flattening of the T wave with weakness and poor contraction of the wall of the ventricles;
    • reduction of all teeth due to impaired contractile function of the myocardium;
    • irregular heart contractions – heart rhythm disturbances;
    • incomplete blockade of the legs of the bundle of His – impaired conduction of impulses in the ventricles.

    These changes indicate violations of the properties of the cells of the contractile myocardium and the conductive system.

    In some cases, pharmacological tests are performed. The patient is injected with 4-6 g of potassium chloride and then repeated ECG. If the indicators returned to normal, then the cause of the deviations is a deficiency of potassium in the cells. The same test is carried out with obzidan (anaprilin) ​​60-80 mg. If the work of the heart normalized an hour after taking the drug, then the cause of the disorders is the excessive effect of catecholamines on the heart.

    Echocardiography (ultrasound of the heart)

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    • decreased motor activity;
    • symmetric thickening of the walls of the ventricles;
    • impaired contractility of the heart;
    • myocardial edema with MKD caused by hypothyroidism;
    • diastolic function of the left ventricle is impaired. It is not flexible enough and supple, therefore it is poorly filled with blood during the relaxation period. In this regard, the volume of blood entering the aorta decreases – up to 40% of the norm;
    • disturbed systolic ventricular function. They do not contract much and push out the reduced volume of blood in the arteries.

    These deviations occur in the late stages of myocardiopathy. Most patients have no symptoms.

    5a8f133d9221f5a8f133d9277a - Myocardial dystrophy of complex genesis treatment

    • a decrease in pressure in the chambers of the heart and blood vessels is a consequence of a decrease in the contractile function of the heart.
    • an increase in the speed and volume of circulating blood during MCD caused by thyrotoxicosis.
    • reverse flow of blood from the ventricles to the atria in case of valve malfunction.
    • signs of heart pathology that caused the appearance of myocardial dystrophy (heart defects, chronic heart failure).

    Nuclear magnetic resonance imaging

    • focal or diffuse myocardial lesions;
    • uneven thickening of the walls of the heart (in the early stages) or thinning (in the third stage);
    • enlargement of the chambers of the heart.

      decreased heart pulsation;

  • enlargement of the heart to the left;
  • congestion in the lungs due to overflow of blood in the pulmonary vessels in patients with distant myocardial dystrophy.
  • Blood test
    usually corresponds to the norm.

    The difficulty in making the correct diagnosis for myocardial dystrophy lies in the absence of changes in the study at the first stage of the process. At this stage, only the underlying disease, for which secondary myocardial dystrophy is typical, can be detected.

    Survey methodCharacteristic changes
    System InspectionHeart enlargement with displacement of borders to the left

    Irregular heartbeat (sinus arrhythmias)

    Auscultation (assessment of heart sounds by ear)Moderate muting at all points

    Weakness of the first tone at the heart apex

    Weak systolic murmur

    Electrocardiography (ECG)Sinus arrhythmia (extrasystole, increased or decreased heart rate)

    Low voltage ventricular complex

    Partial blockade of the legs of the bundle of His

    Violation of repolarization (recovery after contraction) of the heart

    ECG with drug samples (potassium, beta-blockers)Improving pathological changesVelergometry (ECG under physical exertion)No increase in ejected volume when blood is reduced

    Reduced exercise tolerance

    Inability to fully perform the required load

    Ultrasonographic Examination (Ultrasound)Heart enlargement

    Expansion of the cavities of the heart chambers in the third stage of the disease

    Decreased blood volume ejected during myocardial contraction in the phase of organ dysfunction

    Thallium scintigraphy 201Violation of the passage of potassium and sodium ions through the cell wall

    Pathology of myocardial metabolic processes

    Magnetic resonance imaging (MRI) with radioactive phosphorusReducing the amount of energy reserves of heart muscle cells

    Change in pH (acidity) of the cell fluid

    Myocardial biopsy (tissue sampling) with histochemical analysisPathology of enzymatic metabolism in heart tissue

    Myocardial fiber destruction

    Organ Cell Changes

    The most accurate diagnostic method is to take myocardial tissue, but, given that the procedure requires a puncture of the heart, indications for it are extremely limited. A biopsy is performed only in difficult diagnostic situations when myocardial dystrophy cannot be established by other methods.

    The diagnosis of myocardial dystrophy is a diagnosis of exclusion. This pathology is established only after all other diseases of the cardiovascular system are excluded, since it does not have specific objective signs. Only after a reliable exclusion of cardiomyopathy, myocarditis, coronary heart disease and other pathologies, the diagnosis is considered confirmed, of course, if there is the appropriate examination data. The diagnostic program includes the following methods:

    1. Palpation, auscultation of the heart. The expansion of the borders of the heart, heart rhythm disturbances, weakening of the first tone in the zone of the cardiac apex, systolic murmur are revealed. Most often, the so-called pendulum rhythm, gallop rhythm, or atrial cardiac arrhythmia are related to rhythm disturbances.
    2. X-ray of the heart and chest. It shows an increase in heart size, weak pulsation along the contour of the ventricles.
    3. ECG. As a rule, in addition to the above types of arrhythmias, there are conduction disturbances, complex rhythm disturbances, a drop in the voltage of the ECG teeth, ST segment depression, changes in the T wave. In the early stages of the disease, sinus bradycardia, tachycardia may be present.
    4. Bicycle ergometry and ECG monitoring. Necessary for the differentiation of myocardial dystrophy with coronary insufficiency and coronary heart disease.
    5. Ultrasound of the heart or echocardiography. They are necessary to exclude the diagnosis of hypertrophic cardiomyopathy and valvular defects.
    6. Pharmacological tests (for example, taking Nitroglycerin, Anaprilin, the introduction of calcium chloride). They are required to exclude various autonomic dysfunctions and hemodynamic disturbances and confirm the diagnosis of MCD.
    7. Various laboratory tests to find the cause of myocardial dystrophy (tests for hormones of the ovaries, pituitary, adrenal glands, thyroid gland, blood biochemistry, etc.).
    8. Myocardial biopsy. It is used in advanced stages of MCD to assess the degree of fatty degeneration, sclerosis, myocardial necrosis.

    In order to accurately establish the diagnosis of “myocardial dystrophy”, to prescribe treatment, a complex and thorough medical history is required, as well as laboratory and instrumental examination. This is a very important procedure to rule out errors. All cardiac pathologies are preliminary detected. So, diagnostic measures include the following stages of the examination:

    1. Initially, palpation, cardiac auscultation is performed in order to determine the cardiac boundaries, identify cardiac rhythmic disturbances, cardiac apex tones, noise and so on.
    2. An x-ray of the chest, heart helps determine the size of the heart, the degree of its increase, the pulsation of the ventricles. ECG, bicycle ergometry are used to detect coronary insufficiency, ischemic disease. An ECG will also show changes in the myocardium, which type of arrhythmia is present.
    3. Ultrasound, echocardiogram – to detect valvular defects.
    4. Pharmacological tests – for the susceptibility of drugs and confirmation of the diagnosis.
    5. Laboratory tests – to determine the causes that contribute to the occurrence of myocardial dystrophy.
    6. Hormonal analyzes of the pituitary gland for hormones of the ovaries, adrenal glands, and thyroid gland.

    An analysis of a heart biopsy is also performed, but it is done when the disease is already at the 2-3 stage of development. And that’s not all. The patient must remember that nothing can be hidden from the doctor, even if the disease was triggered by alcohol or drug addiction. It is impossible to choose the right complex of treatment without the correct history.

    Treatment and prevention

    The most effective prevention of myocardial dystrophy in children is a healthy and active lifestyle. Therefore, it is very important to teach a child to this from an early age, so that in adulthood he can easily adhere to proper nutrition and abandon bad habits.

    To prevent the disease, it is important to exclude the long-term existence of hormonal disorders, poisoning and overdose of drugs, to refuse excessive intake of alcohol. It is necessary to sanitize the foci of infection, to prevent poor nutrition with a deficiency of protein and vitamins. It is important to practice adequate physical activity, but not to allow overvoltage, and also to lead a healthy lifestyle in general.

    The prognosis is most favorable for dyshormonal myocardial dystrophy, since after eliminating the malfunction, the heart condition returns to normal. Adverse to the prognostic calculation is the presence of severe, progressive pathologies that caused MCD – diabetes mellitus, coronary heart disease, etc.

    In order to reduce the likelihood of an ailment, it is necessary to lead a healthy lifestyle. It includes:

    • compliance with the regime of the day and sleep for at least 8 hours;
    • regular physical activity, swimming, exercise therapy, breathing exercises;
    • avoidance of overheating and hypothermia of the body;
    • Compliance with diet and the principles of proper nutrition;
    • getting rid of excess weight;
    • quitting alcohol and smoking;
    • prevention of mental overload.

    Pathological changes can be prevented by promptly contacting a specialist and following his instructions. The prognosis depends on the degree of heart damage.

    In order to avoid the negative consequences of the disease, it is necessary to consult a cardiologist immediately if symptoms appear. The doctor will be able to determine the cause of the disease and prescribe the necessary drugs for treatment.

    The most effective prevention of myocardial dystrophy in children is a healthy and active lifestyle. Therefore, it is very important to teach a child to this from an early age, so that in adulthood he can easily adhere to proper nutrition and abandon bad habits.

    Svetlana Borszavich

    General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
    Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
    The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
    The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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