Myocarditis and cardiomyopathy

Abstract

Although overall myocarditis accounts for a minority of cardiomyopathy and heart failure presentations, the clinical presentation is variable and the pathophysiology of myocardial damage is unique. Cardiac MRI has significantly improved diagnostic abilities, but endomyocardial biopsy remains the gold standard. However, current treatment strategies are still focused on routine heart failure pharmacotherapies and supportive care or cardiac transplantation/mechanical support for those with end-stage heart failure.

Some Features of Clinical Laboratory and Instrumental Research in Chronic Inflammatory Diseases of the Nose and Paranasal Sinuses in Patients with Myocarditis

“…Rhinosinusitis is an inflammation of the nasal mucosa and paranasal sinuses (PNS), almost always caused by stagnation of the secret and a violation of aeration of the PNS. The starting point in the development of rhinosinusitis is usually a viral infection [4].…”

“…Factors that violate the patency of the natural openings of the paranasal sinuses and the mechanisms of their aeration and cleansing include abnormalities of the development of the nasal concha, curvature of the nasal septum, and deformation of the nasal valve, whose functions have not yet been fully studied [2,3,9,12]. The rendered pathological action creates the conditions for blockade of the ostiomeatal complex, and subsequently the development of the inflammatory process in the paranasal sinuses [4,5,6,7,9,11]. In conditions of stagnation of the secret and a decrease in the partial pressure of oxygen in the PNS, favorable conditions are created for the development of a bacterial infection [12,13,14,15].…”

“…It has been proven that there is a direct connection between influenza and acute respiratory infections with subsequently developing chronic therapeutic pathology and serious somatic complications [22]. It is considered possible to develop primary heart damage in acute infectious diseases [4,6,12], myocarditis and dilated cardiomyopathy in patients who have had a viral infection [1,9,16]. Of particular relevance is the study of the role of inflammatory diseases of the ENT organs in the occurrence of heart pathology, which very often are the cause of dystrophy of the heart muscle [2], myocarditis and rheumatism [6,8].…”

“…Endoscopy of the nasal cavity is the most reliable method for examining the nasal cavity, the condition of the paranasal sinuses and their natural anastomoses and plays a dominant role in the diagnosis, an objective assessment of the effectiveness of the treatment and the choice of the best option for surgical intervention [4,12].…”

Atherosclerosis as Pathogenetic Substrate for Sars-Cov2 &lsquo;&lsquo;Cytokine Storm&rsquo;&rsquo;<strong> </strong>

“…Interestingly, Wang et al [48] Besides ACS, cardiovascular system may be involved in patients affected by heart failure, due to hemodynamic decompensation, and in small percentage of cases, acute myocarditis may occur without prior evidence of CVD, due to ACE2 presence on cardiac myocytes, leading potentially to chronic dilated cardiomyopathy [46,51,52].…”