1. Differential diagnosis
1. Differentiation between myocarditis and dilated cardiomyopathy Myocarditis with enlarged left ventricle and diffuse reduction of wall motion should be differentiated from left heart type dilated cardiomyopathy, and right heart type myocarditis should be distinguished from right heart type dilated cardiomyopathy Phase identification. The difference is that myocarditis impaired heart function appears earlier than the heart chamber enlargement, and the changes in the echocardiogram of the heart often show dynamic changes, and most cases can return to normal after several months of treatment.
2. Differentiation between myocarditis and hypertrophic cardiomyopathy Patients with myocarditis have thickened ventricular walls, thickened papillary muscles, chordae, endocardium, and valves, which are easily confused with hypertrophic cardiomyopathy. However, most myocarditis changes such as hypertrophic wall and thickened valve can be reduced or disappeared after a few months, which can be used to distinguish.
3. Differentiation between myocarditis and endocardial fibrosis (EFE) Fulminant endocardial fibrosis is more common in infants younger than 6 months. The main clinical manifestation is recurrent and difficult-to-correct heart failure. Heart failure can also occur. The heart is obviously enlarged due to shock. The difference from myocarditis is that EFE is characterized by thickening of the endocardium, the cardiac changes have no obvious dynamic changes, and the prognosis is serious. However, EFE may also be the result of the development of viral myocarditis, so the distinction between the two still needs to be considered from the development of the disease.
2. Matters needing attention
1. Since the echocardiographic manifestations of myocarditis often show dynamic changes, the echocardiogram should be re-examined, paying attention to the comparison of the results of the previous and post-examination.
2. The echocardiographic manifestations of acute or chronic myocarditis can vary from completely normal to obviously abnormal. These changes can be similar to hypertrophic cardiomyopathy and dilated cardiomyopathy, or coronary heart disease and myocardial infarction. The echocardiographic findings are not specific. Sex.
III. Clinical significance Although the ultrasound manifestations of
myocarditis are not specific, the combination of clinical manifestations has important auxiliary value for the diagnosis of this disease. Myocardial biopsy provides a reliable pathological basis for the diagnosis of this disease. Echocardiography can fully understand the extent and extent of myocardium, heart valves, pericardium and cardiac function involvement. It is of great significance for guiding treatment and judging prognosis. It is the first choice, reliable, practical, and noninvasive method for follow-up examination of this disease.
More professional knowledge! Please pay attention to the WeChat public account "Ultrasound Palm"
