Even myocarditis caused by infection is not just viral infection, fungal parasites and bacteria can infect myocardial myocarditis. It is just that myocarditis caused by viruses is the most common in clinical practice, and there is the old doctor's catchphrase that viral myocarditis is the saying.

Clinicians discuss that myocarditis basically revolves around viral myocarditis, because nine out of ten patients are viral infections.

Like myocarditis, dilated cardiomyopathy is caused by immune factors and virus infection. Among them, enterovirus and cytomegalovirus infection detected in myocardial biopsy have been confirmed to be directly related to dilated cardiomyopathy. Coincidentally, myocarditis also has the conditions of infection with these two viruses.

This is the point where Li Chengyuan and Dr. Dong argued. Indeed, it is not yet certain whether this infection caused two diseases at the same time, or whether one disease first occurred and then gradually led to the occurrence of another disease.

What is the significance of this debate? It is because the occult myocarditis mentioned by Xie Wanying just now was not able to detect and do examinations in time, which eventually led to the death of a patient with heart failure.

Li Chengyuan denied her statement, believing that the patient had no occult myocarditis at all. He had dilated cardiomyopathy at the beginning, so it could not be found clinically. The symptoms of dilated cardiomyopathy can be more concealed, and the onset is slow, and the course of serious symptoms can last for more than ten years.

Dr. Dong agrees with Xie Wanying's view, which is equivalent to his belief that as long as it is viral myocardial infection, it should be a process from myocarditis to dilated cardiomyopathy. The reason is that he has seen many such patients in clinical practice.

The difference between an internal physician and a surgeon is here. Patients with myocarditis usually do not have the cardiothoracic surgery department, but go to the cardiovascular department for medication first. They have to wait until the patient has completely failed and considers a heart transplant, and they will switch to the surgery department for surgery. The surgeon only recognizes anatomical results. Myocarditis is the deformation and necrosis of cardiac myocarditis, and the characteristic of dilated cardiomyopathy is ventricular enlargement. How can it be the same?

"Permanent myocarditis can lead to myocardial remodeling." Xie Wanying said.

"Yes. As she said, that's it." Dr. Dong applauded her words.

Li Chengyuan did not give in: "Your statement cannot prove 100% that dilated cardiomyopathy comes from persistent myocarditis. It is possible that both of them will occur at the same time."

Xie Wanying suddenly thought of something when she heard the senior's words and stopped talking.

Huang Zhilei and Xin Yanjun whispered: "They quarrel over and over again, what did they quarrel? Now, it should be suspected that it is myocarditis, right?"

Elevated troponin represents a myocardial injury. As one of the important indicators for assisting the diagnosis of myocarditis, it has clinical guidance value. To diagnose myocarditis, the patient needs to have clinical symptoms related to myocarditis, such as chest pain, chest tightness, wheezing, heart failure, and palpitations. If the patient does not have obvious symptoms, other tests are needed to confirm whether it is myocarditis. Therefore, this patient is now in the initial stage when the doctor suspects whether it is myocarditis. Next, the patient should be subjected to electrocardiogram and echocardiography as soon as possible.

If you want to ask the gold standard for myocarditis, you must have an endocardial myocardial tissue biopsy.
Chapter completed!