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Диагноз «миокардит»: маскирует или маскируется?
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Nikitina I.L., Vershinina T.L., Vasichkina E.S. The diagnosis of myocarditis: masks or disguises? Consilium Medicum. Pediatrics (Suppl.). 2016; 4: 75–81.
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Ключевые слова: миокардит, кардиомиопатия, дети, подростки, хроническая сердечная недостаточность, аритмия.
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To date, myocarditis continues to pose significant challenges for the diagnosis due to the variety of clinical presentations, the limited availability of a number of diagnostic procedures. From the review of the scientific literature, and from the author's own experience it shows that myocarditis can be accompanied by severe congenital abnormalities of myocardial non-inflammatory genesis, may be an independent disease, and may mask a pathology unrelated to myocardial inflammation. This publication presents clinical observations, confirming the diversity of clinical masks of myocarditis, as well as justifying the recommendations meticulous serial diagnostic search with the ability to audit previously available representations in respect to difficultly treated heart disease in children and adolescents.
Key words: myocarditis, cardiomyopathy, children, adolescents, chronic heart failure, arrhythmia.
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1. Kindermann I, Barth C, Mahfoud F et al. Update on myocarditis. J Am Coll Cardiol 2012; 59: 779–92.
2. Сaforio AL, Pankuweit S, Arbustini E et al. Current state of knowledge on aetiology, diagnosis, management ant therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. ESC Report Eur Heart J 2013; 34 (33): 2636–48.
3. Canter CE, Simpson KP. Diagnosis and Treatment of Myocarditis in Children in the Current Era. Circulation 2014; 129 (1): 115–28.
4. Klinicheskie rekomendatsii po detskoi kardiologii i revmatologii. Pod red. M.A.Shkol'nikovoi, E.I.Alekseevoi. M., 2011. [in Russian]
5. Richardson P, McKenna W, Bristow M et.al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of Cardiomyopathies. Circulation 1996; 93 (5): 841–2.
6. Cooper LTJr. Myocarditis. N Engl J Med 2009; 360: 1526–38.
7. Sagar S, Liu PP, Cooper LTJr. Myocarditis. Lancet 2012; 379: 738–47.
8. White JA, Abdel-Aty H, Gutberlet M et al. International Consensus Group on Cardiovascular Magnetic Resonance in Myocarditis. Cardiovascular magnetic resonance in myocarditis: AJACCWhite Paper. J Am Coll Cardiol 2009; 53 (17): 1475–87.
9. Nugent AW, Daubeney PE, Chondros P et al. The epidemiology of childhood cardiomyopathy in Australia. New Engl J Med 2003; 348 (17): 1639–46.
ФГБУ Северо-Западный федеральный медицинский исследовательский центр им. В.А.Алмазова Минздрава России. 197341, Россия, Санкт-Петербург, ул. Аккуратова, д. 2
*nikitina0901@gmail.com
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I.L.Nikitina*, T.L.Vershinina, E.S.Vasichkina
V.A.Almazov North-West federal medical research center of the Ministry of Health of the Russian Federation. 197341, Russian Federation, Saint Petersburg, ul. Akkuratova, d. 2
*nikitina0901@gmail.com