Viral myocarditis
Viral myocarditis
[Overview]
Viral myocarditis is a violation of the heart due to the virus, causing symptoms of myocarditis caused by a change in heart disease. After the acute viral infection or disease, and palpitations, chest tightness, chest pain, shortness of breath and other heart symptoms, and ECG abnormalities as the main clinical features.The disease can occur at any age, but more common in young people, more men than women, higher in summer and autumn season. Incidence of less than 6 months for the acute phase, 6 months to Wei-year recovery period, more than 1 year of chronic phase. Most patients with myocarditis can be cured, some patients have some degree of cardiac signs and ECG abnormalities, but her condition life time, mostly after acute myocarditis caused by myocardial scar, known as myocarditis sequelae. Very small number of patients in the acute phase of severe cardiac arrhythmia, acute heart failure and cardiogenic shock and death.Myocarditis is a traditional Chinese medicine, “palpitations,” “Chest”, “edema”, “palpitation”, “Consumption” and other areas.
[Etiology and pathology]
Although the cause of myocarditis evils, eating unclean, fatigue, emotions fail, etc., but mainly to exogenous cult poison, Nesher pericardium due.
Pathological changes of warm toxin, the passage in the lung health, good and evil struggle to pay, is virtual evil into, Nesher pericardium, heart vessel invasion, caused by efforts stasis, and see chest pain, palpitations shortness of breath, pulse statement on behalf of embolism. Or cold poison of evil, stagnate Xinmaitong, Bi blocking efforts to run may cause chest tightness, pulse delay; evil sad Yang, Yang and water pan, measure water vapor, see Ling heart palpitations, asthma, swollen limb embolism.Or the phlegm, however, is re-toxic heat invasion heart disease compared with the results, stasis on systolic and see tired, bitter mouth, heart hold back pain. Evil protracted course of time, its potential has been slow, Qi, mind dystrophy, the Shenpi, palpitations Zheng Zhong, five upset hot, pulse knot on behalf of the other; gas yang deficiency, loss of agitation pulse measurement, chest tightness, dizziness, pulse delay.
[Diagnostic points
1 The main clinical manifestations 1 to 3 weeks before the onset of a history of acute viral cold or flu while chest tightness, palpitations, shortness of breath, fatigue, severe manifestations of heart palpitations, breathing difficulties, chest pain, edema, syncope, or even killed. Cardiac auscultation shows arrhythmia, tachycardia, bradycardia, heart sounds low blunt and so on.
2 laboratory ECG ST-T segment changes, a variety of arrhythmias, including ventricular, atrial, junctional premature beats, and a variety of conduction block and so on. Anti-myocardial antibody positive.
[Dialectical type]
1 cult poison invasion heart symptoms: fever, chills, headache, body Chu, stuffy nose, sore throat, or with cough, palpitations, shortness of breath, chest tightness, chest pain. Red tongue, thin pulse statement on behalf of or to promote.
Syndromes: warm cult poison, hit the muscular form, good and evil struggle to pay, and fever chills; lung failure Xuan Wei Chu headache, body measurements, stuffy nose, sore throat, or with cough; Xie Sheng is true, the cult poison invasion, in homes in the heart, damage Xinmaitong to curb blood, the heart palpitations shortness of breath, chest tightness, chest pain; red tongue, thin pulse statement on behalf of, or promote, are cult poison invaded the heart of the levy.
2. Condensate heart cold virus symptoms: fever, aversion to cold, no sweat, head and body pain, sorrow and grief joints, chest tightness or pain, palpitations, shortness of breath. Pale tongue, thin white veins tight late or late, or knot generation.
Syndrome analysis: cold outside attack, good and evil struggle to pay, then the fever chills;
Evil muscle bundles form through the air negative, no sweat, head and body pain, joint pain;
Cold drugs intrusion, stagnate systolic, heart failure transportation measure chest pain, palpitations, shortness of breath; pale tongue, thin white veins tight late or late, or statement on behalf of the levy are cold drugs stagnate.
3 water vapor Ling heart symptoms: chest tightness, wheezing, not supine, limbs not warm, purple lips, bloating limb swelling.Purple tongue, greasy tongue coating, pulse.
Syndrome analysis: evil sad Yang, Yang and water pan, water and gas Ling heart Blockage of heart vessel, the chest tightness, wheezing, not supine, lips blue; water vapor inside the stop, the abdominal distension limb swelling; yang is weak, then limb temperature; purple tongue, greasy tongue coating, pulse, blood stasis are the yang of the levy.
4. Phlegm each node symptoms: chest tightness, palpitations, precordial hold back pain, mouth bitter greasy, or dry mouth and constipation; fat red tongue, yellow greasy fur, dirty or greasy, slippery pulse, or promote.
Syndrome analysis: the phlegm, however, is toxic heat invasion of the heart, and sputum each node, stasis Xinmaitong, so see chest tightness, palpitations, precordial pain, choke; and the day filled with bitter phlegm tired; measured heat Shangyin Tianjin portdry constipation; fat red tongue, yellow greasy fur, dirty or greasy, slippery pulse, or promote, are filled with phlegm, blood stasis in the heart vessel of the levy.
These four types are found in acute phase of viral myocarditis.
5. Qi and Yin Deficiency symptoms: palpitations, chest tightness, shortness of breath, tired body fatigue, or five upset hot, spontaneous sweating. Mamillata chun, thin fur, thready and weak pulse, or knot generation.
Syndromes: cult poison invasion heart falling, burns the heart yin, heart damage and gas, heart failure has raised, the palpitation; gas is not transported blood, heart hysteresis, the chest tightness shortness of breath; Yin Deficiency, Hot in force, the tired body fatigue, night sweats, five upset sweat tears; mamillata chun, thin fur, thready and weak pulse or intermittent, are the heart of the Qi and Yin Deficiency of the levy.
6 gas-yang deficiency symptoms: chest tightness, palpitations, shortness of breath, dizziness, pale white, cold chills, loose stools.Pale tongue, thin pulse was late.
Syndrome analysis: evil hurt gas yang, yang lack of chest, heart failure operation, it is chest tightness, palpitations, shortness of breath; blood is not on the wing dizziness; Yang lost in the operation temperature, the pale white, cold chills, they Tong ; pale tongue, white coating slip, the pulse small and late, are air-yang deficiency symptoms.
Above two types, common in chronic viral myocarditis.
[And Treatment]
1 cult poison invasion heart rule is: detoxification, sparse evil pure heart.
Recipe: Yinqiaosan addition and subtraction.
15 grams of honeysuckle forsythia 15 Winter oats 15 g Arctium Radix 15 g 15 g 12 g Radix Gardenia 9 grams berberine bamboo 9 g 3 g 5 grams of licorice subtraction with the disease: severe heat, add gypsum 30 g (fry) to the Qing in the heat; throat pain, fever, plus habitat 15 grams, Scrophulariaceae 15 grams, 6 grams Mabo, to clearing away heat and pharynx; abdominal pain, diarrhea, plus Pulsatilla 30 grams, 12 grams Qin skin to bowel detoxification.
2. Condensate cold poison heart rule is: dispelling by evil, temperature dependent Xinmaitong.
Recipe: Decoction Mahuangfuzixixin.
Monkshood ephedra 9 g 9 g 9 g Gui Zhi Asarum 5 g Codonopsis 15 Kdan Ref 15 grams Zhigancao 9 grams jujube 5 subtraction with the disease: cough, white sputum, plus almond 9 grams, 9 grams Peucedanum , Coltsfoot Flower 9 grams, 9 grams Aster to Xuanfei Huatanzhike.
3 water vapor Ling heart rule is: yang Qi, Blood and Water.
Recipe: Shen Fu Tang Lingguizhugan decoction.
30 grams of astragalus Monkshood Codonopsis 15 grams 12 grams 10 grams Atractylodes Guizhi 15 g Poria 15 Kdan Ref 15 Winter oats 12 grams subtraction with the disease: chest tightness, phlegm, add melon wilt 15 grams Allium 6 g, Pinellia 12 grams, with phlegm Chest.
4. Phlegm each node rule is: Thanh Hoa heat phlegm, promoting blood circulation.
Recipe: Small Xianxiong soup Danshen Decoction.
黄连 5 g Pinellia 12 grams right Trichosanthes 20 g 15 g solid state 10 Kdan reference book 12 g peach kernel 9 grams turmeric 15 grams subtraction with the disease: dry mouth, constipation, plus Scrophulariaceae 15 grams, rhubarb 6 grams ( later), the Yin laxative.
5 Qiyinliangxu rule: Qi Yin, Anshen.
Recipe: Decoction ShengmaiYin together the spleen.
Astragalus 24 g heterophylla 20 Winter oats 15 g Schisandra odoratum 12 g 6 g 9 g Fu Shen Angelica Suanzaoren 12 g 15 g 5 g of Polygala Zhigancao 9 grams subtraction with the disease: chest pain, plus turmeric 10 grams, 15 grams of Salvia, dalbergia 5 grams to qi and blood circulation; spontaneous sweating or night sweats, plus calcined keel, the 30 grams of calcined oyster (fry), floating wheat 15 grams, to the town center sweating.
6 gas-yang deficiency rule is: the heart tonic air, warm-up heart-yang.
Recipe: Baked Licorice Decoction Pill addition and subtraction.
Codonopsis 15 grams Zhigancao Monkshood 9 g 9 g 9 g Gui winter oats ginger 5 9 g Rehmannia 12 grams 12 grams yam Cornus 9 Kdan reference 15 grams 6 grams of saffron jujube 5 subtraction with the disease: long-term medication, there are signs of the heat, shall reduce it aconite, ginger and other warm dry goods.
[Chinese medicine]
1. Ningxin capsules: 2 capsules, 3 times a day.
2. ShengmaiYin Liquid: Each 10 ml, 3 times a day.
[Side] is simple
American ginseng 6 grams, 12 grams of Radix, Schisandra decoction of 5 g of ice, several times a day on behalf of the tea.For patients with chronic viral myocarditis uniforms.
[] Other therapies
Injection: 20 ml Shengmai injection of 5% glucose in 20 to 40 ml intravenous injection, once daily, 2 to 4 weeks for a course of treatment for acute viral myocarditis, chronic phase is a Qi and Yin Deficiency .
Acupuncture: Select Xinyu, Jue Yin Yu, internal relations, Yang Ling Quan, Sanyinjiao, unilateral acupoints, used interchangeably, reinforcing-reducing, day 1, l-week course of treatment.
Food therapy: broiler l only, longan IO grams, Radix 15 g, and salt, wine, ginger and other spices in cooking boilers put together after the consumption. For viral myocarditis or chronic phase of recovery eat.
[Notes]
1 acute exacerbation of viral myocarditis should actively seek medical treatment and bed rest, within six months to minimize the activities, in order to facilitate condition improved recovery.
2 viral cold or diarrhea, should be treated.
3. Rest appropriately, beware of emotional stimuli.