What are the major characteristics of diphtheritic myocarditis? Read this one article to understand
It occurs mostly in children, is prone to occur in winter and spring, spreads through droplets, toys and clothing, invades the respiratory tract such as the tonsils and throat and is complicated by myocarditis, while also showing respiratory, cardiac, circulatory, digestive and systemic symptoms, causing cardiogenic shock, etc. These are all characteristics of diphtheritic myocarditis. In addition, there is rapid onset and progression, with necrosis and scarring appearing in the lesion area, leading to degeneration of the cardiac conduction system, congestive heart failure, etc.
Specifically, in terms of the classification of diphtheria, there are nasal diphtheria, pharyngeal diphtheria, laryngeal diphtheria, diphtheria of other sites, etc. From the perspective of onset and symptoms, after children and other groups are infected with Corynebacterium diphtheriae, after an incubation period of 1 to 7 days, fever, nausea, vomiting, and the formation of diphtheritic pseudomembranes in the throat and other sites will appear, along with mucosal necrosis, local lymph node enlargement and respiratory tract obstruction, inspiratory stridor or the appearance of three depression signs, etc.
When diphtheria causes involvement of the circulatory system and systemic symptoms appear, it indicates that myocarditis has already developed as a complication. Symptoms include pale complexion, fatigue and weakness, difficulty breathing, cyanosis, etc. At this time, examination may reveal mild or moderate cardiac enlargement, heart sounds so dull that they resemble fetal heart sounds, and in most cases atrioventricular block will occur, with bradycardia or tachycardia, and in the precordial area a blowing systolic murmur and a diastolic gallop rhythm may also be found.
When diphtheritic myocarditis progresses to widespread myocardial lesions, cardiogenic shock will occur, and it appears two to three weeks after onset, with warning signs such as nausea, vomiting, pale skin, and abdominal pain appearing first, after which cold limbs, weak and thready pulse, decreased blood pressure, and shock may occur. The cause of shock is also that the toxin produced by Corynebacterium diphtheriae has toxic effects on peripheral small blood vessels and the vasomotor center, leading to pulmonary congestion and systemic circulatory congestion, causing congestive heart failure and promoting the occurrence of shock.