Changes in the myocardium

From CardioWiki

Diffuse changes in the myocardium are not a disease, but a syndrome, if found, the doctor should determine what caused it : the serious illness or minor metabolic disorders. The emergence of such signs is due to the fact that some cells with biochemical shifts start to work and contract not quite correctly, as a result of which the electrical activity of the parts of cardiac muscle, recorded on the ECG, will not be uniform. In other words, diffuse changes in the myocardium are clusters of altered cells through which passage of electrical impulses are disturbed.

Disturbances in the activity of cells can be not only diffuse, that is, covering areas in all parts of the heart, but also focal, for example, in the formation of small or large scars in the myocardium. Scars are represented by a connective tissue that cannot conduct impulses and is electrically inert, which is seen by the doctor on the ECG.

The reason for such deviations on the ECG can be both harmless, and quite serious, which poses a threat to human life. In order to more accurately know what exactly caused diffuse or focal changes in the myocardium, it is necessary to carefully examine the patient. Pathological changes in the myocardium can be caused by different processes, so several subgroups are distinguished among them.

  1. The causes of inflammatory changes is myocarditis - infectious or aseptic (without the involvement of microorganisms) inflammation of the heart muscle. As a rule, the areas of inflammation are diffuse, but they can also occur in the form of foci.
  2. Dystrophic changes in the myocardium are characterized by metabolic disorder in the cardiac cells, caused by non-inflammatory and non-coronary (not caused by coronary artery disease) diseases. Literally this means that myocardial cells lack nutrients to carry out their vital functions, which leads to a non-uniform contraction of them. In another way, this condition is called cardiac dystrophy. This state can occur in the following cases:
    • Severe violations of the liver and kidneys function with the development of insufficiency of these organs, as a result of which toxic products of metabolism accumulate in the blood,
    • Diseases of the endocrine organs - diabetes mellitus, adrenal gland tumors, hyperthyroidism, as a result of which are excess hormones or insufficient absorption of glucose by cardiac cells lead to disruption of intracellular metabolism,
    • Constant stress, exhausting physical activity, malnutrition and starvation, chronic overwork,
    • In children, in addition to the previous reason, the changes in the myocardium can be caused by increased emotional and mental stresses in the absence of sufficient mobility, as a result of which vegetative-vascular dystonia and violations of the regulation of the heart from the side of the nervous system develop,
    • Anemia (a decrease in hemoglobin in the blood and, as a consequence, oxygen starvation of myocardial cells),
    • Acute and chronic infectious diseases (influenza, malaria, tuberculosis),
    • Fever and dehydration of the body,
    • Lack of vitamins in food,
    • Acute and chronic intoxication (alcoholism, occupational poisoning with chemicals, etc.)
  3. Metabolic changes in the myocardium are caused by a violation of repolarization processes in muscle cells. In addition to conditions capable of provoking myocardial dystrophy, it can be caused by coronary artery atherosclerosis and ischaemic heart disease, arterial hypertension, arrhythmia, myocardial hypertrophy. That is, those conditions in which the heart receives insufficient nutrients and microelements. It can be said that the violation of repolarization processes and moderate changes in the myocardium mean that it is not so much coronary heart disease as the first bell for the patient that the blood supply to the heart muscle is broken and in the near future he has the possibility of developing myocardial ischemia.
  4. Cicatricial changes in the myocardium indicate that the heart muscle had previously undergone an inflammatory process or had a myocardial infarction with necrosis (death) heart cells. Cicatricial changes after myocarditis, also called cardiosclerosis, are usually diffuse, and after a myocardial infarction are focal. The difference between these terms is that cardiosclerosis is a diagnosis reflecting the disease, and cicatricial changes of the myocardium is a pathomorphological basis of the disease, reflected on the ECG. Postinfarction cardiosclerosis is more often represented by focal scar, and can be large or small, and located along one or several walls of the left ventricle - the inferior (posterior), anterior or lateral wall.

As a rule, in the absence of cardiac pathology, ECG changes do not manifest themselves clinically and are only an accidental finding in the examination, especially when it comes to minor or moderate changes. However, the patient must undergo further follow-up as directed by the doctor to make sure that he does not have any initial signs of any disease and, if necessary, begin timely treatment.

Significant changes in the heart muscle in most cases indicate a cardiological or other disease, so there can be the appearance of symptoms from the underlying disease. These include pain in the heart with angina due to myocardial ischemia; shortness of breath and swelling in cardiosclerosis; signs of chronic heart failure after a previous myocardial infarction; trembling of limbs, weight loss and shifting of the eyeballs anteriorly (exophthalmos) with hyperthyroidism; pallor, dizziness and weakness in anemia, etc.

In this regard, a patient with diffuse changes of the myocardium on the ECG should remember that if he has unpleasant symptoms, he should see a doctor as soon as possible to find out the cause of this condition. In each specific case, only the doctor, when examining the patient, can decide whether there is a need for further examination. So, for example, with minor diffuse changes in the myocardium in adult patients without signs of serious illness, the doctor can limit himself to recommendations for correcting blood pressure, maintaining a healthy lifestyle and taking vitamins. If there is a suspicion of a disease that caused changes in the myocardium, additional diagnostic methods may be prescribed.

Therapy of absolutely any disease begins with a correction of the lifestyle and the basis of rational nutrition. When it comes to the dystrophic or metabolic changes in the myocardium of slight and moderate degree of severity, sleep regimen, rest and diet are of fundamental importance. If the significant diffuse changes of the myocardium are caused by the disease, its treatment is required.

In conclusion, it can be noted that if the ECG protocol shows diffuse changes in the myocardium, do not panic in advance, because minor and moderate changes can occur in a relatively healthy person with a metabolic disorder. But all the same it is necessary to address to the doctor as only the doctor can appoint the necessary examination and treatment if such necessity arises.

This pathology can be detected using ECG Dongle Full [1].