Herz und Viren

Zusammenfassung

Die Myokarditis als entzündliche Herzerkrankung ist weltweit eine der Hauptursachen von akutem Herzversagen, plötzlichem Herztod und dilatativer Kardiomyopathie und als solche unterdiagnostiziert. Virale Infekte und die folgende postvirale Immunantwort sind wiederum Hauptverursacher der Myokarditis in unseren Breitengraden. Die Diagnose wird primär klinisch gestellt und kann durch bildgebende Verfahren wie Echokardiogramm und kardiale Magnetresonanztomografie erhärtet werden. Der Goldstandard der in-vivo-Diagnose bleibt jedoch die Endomyokardbiopsie. Die Ergebnisse der Materialaufarbeitung können hilfreich in der Steuerung spezieller Therapieansätze, wie Immunsuppression bei Virus-negativer chronisch-inflammatorischer Kardiomyopathie, sein. Bis heute beruht die Standardtherapie auf Bettruhe und Herzinsuffizienztherapie, wobei in schweren Fällen ein mechanisches Unterstützungssystem oder sogar die Herztransplantation notwendig werden kann.

Summary

Myocarditis as an inflammatory disease is one of the main reasons for acute cardiac failure, sudden cardiac death and dilated cardiomyopathy worldwide and as such underdiagnosed. Viral infections and the post-viral immune mediated host response are the main causes for myocarditis in the firstworld. The diagnosis is presumed on clinical presentation and on findings in further imaging studies such as echocardiography or cardiac magnetic resonance imaging. Nevertheless endomyocardial biopsy remains the gold-standard for in-vivo diagnosis. Its findings can be helpful in guiding special therapeutic strategies such as immunosuppression in virus-negative chronic inflammatory cardiomyopathy. Until today the standard treatment is physical rest and heart failure therapy, in severe cases even mechanical circulatory support and heart transplantation if needed.

Schlüsselwörter

Myokarditis - viral - pädiatrisch - Endomyokardbiopsie

Keywords

Myocarditis - viral - pediatric - endomyocardial biopsy

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