慢性活动性心肌炎一例

Chronic Active Myocarditis: A Case Report

摘要: 心肌炎是各种原因(病毒感染、免疫系统激活、暴露于毒素或药物等)引起的心肌局限性或弥漫性炎症病变，可导致心脏收缩、舒张功能受损。本文报道1例慢性病程，急性发作，以来势汹汹的呼吸困难、不明原因的心源性休克等为临床表现的慢性活动性心肌炎病例。该病例提示按心脏病常规治疗后临床症状未缓解甚至继续加重时，完善相关检查后排除急性冠脉综合征、缺血性心肌病等，需考虑诊断心肌炎。

Abstract: Myocarditis, characterized by localized or widespread inflammation of the heart muscle, can stem from a variety of triggers such as viral infections, immune system reactions, or exposure to toxins and medications. This condition may result in compromised heart function, affecting both its ability to contract (systolic function) and relax (diastolic function). The case study presented here describes a chronic active myocarditis with a protracted course that manifested acutely, presenting with severe shortness of breath and unexplained cardiogenic shock. It underscores the importance of considering myocarditis as a potential diagnosis when conventional heart disease treatments fail to alleviate symptoms or when they worsen. In such instances, after conducting the necessary diagnostic tests, it is crucial to rule out acute coronary syndrome and ischemic cardiomyopathy before entertaining the possibility of myocarditis.