A seventeen-year-old male presented with severe substernal chest pain after an episode of upper respiratory tract infection. On clinical grounds, a diagnosis of myocarditis was established. He had a peak troponin I le...A seventeen-year-old male presented with severe substernal chest pain after an episode of upper respiratory tract infection. On clinical grounds, a diagnosis of myocarditis was established. He had a peak troponin I level as high as 40.4 ng/dl but interestingly with no abnormal wall motion and normal ejection fraction in echocardiography. Coronary artery disease was excluded with normal coronary angiography. Diagnosis of myocarditis was confirmed with cardiac MRI. After one month, patient had no complaint and ejection fraction were still normal. Our case emphasizes that the troponin levels predict neither the early nor the late outcome of the left ventricular functions in myocarditis, therefore serum troponin I may not be helpful in determining the prognosis of patients with myocarditis.展开更多
Objective: To evaluate the clinical efficacy of Shengmai Powder (SMP, 生脉散) in treating a-cute viral myocarditis objectively. Methods: One hundred and twenty-four patients with acute viral myocarditis were randomize...Objective: To evaluate the clinical efficacy of Shengmai Powder (SMP, 生脉散) in treating a-cute viral myocarditis objectively. Methods: One hundred and twenty-four patients with acute viral myocarditis were randomized into the treated group (SMG, n = 64) and the control group(CG, n = 60 ). Such myo-cardial nutrient medicine as ATP, CoA , Vit-C, were given to both groups. And to the treated group, 40 ml of Shengmai Injection per day was given intravenously for 2 weeks, which was followed by oral intake of Shengmai granule, one package three times daily for another 2 weeks in total. The same anti-arrhythmia agents were applied to both groups, and no fructose-1, 6-diphosphate (FDP) for either. Semi-quantitative scoring method was adopted to observe such symptoms as chest stuffiness, palpitation and chest pain before treatment and four weeks after treatment. Meanwhile, EGG, dynamic ECG by Holter monitor, left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), serum neutralizing antibody of virus Coxsackie B, cardiac troponin I (cTnl) and cardiac troponin T (cTnT) were examined. Results: (1) Compared with the control group, more significant improvement was got in SMG in respects of chest stuffiness, palpitation, chest pain and arrhythmia (P<0.05 or P<0.01). (2) Negative converting rates of cTnl ,cTnT in the two groups were 59.46% vs35.48%, 68.75% vs42.31% respectively ( P<0. 05). (3) LVEDD before and after treatment in SMG was 52. 44 ± 3. 40 mm and 48. 81 ± 2. 23mm respectively, while that in the control group was 52. 31 ± 3. 74 mm and 49. 92 ± 2. 67mm respectively; LVEF before and after treatment in SMG was 60.67 ± 4. 62 % and 65. 02 ± 4. 16 % respectively, while that in the control group was 60.91 ± 4. 26 % and 63. 67 ± 3.17 % . There was obvious improvement in the two parameters in both groups, but the improvement in SMG was superior to that in the control group ( P<0. 05). Conclusion: SMP shows a good effect in improving clinical symptoms and signs, heart function, abnormal ECG and inflammatory injury indexes in patients with acute viral myocarditis.展开更多
文摘A seventeen-year-old male presented with severe substernal chest pain after an episode of upper respiratory tract infection. On clinical grounds, a diagnosis of myocarditis was established. He had a peak troponin I level as high as 40.4 ng/dl but interestingly with no abnormal wall motion and normal ejection fraction in echocardiography. Coronary artery disease was excluded with normal coronary angiography. Diagnosis of myocarditis was confirmed with cardiac MRI. After one month, patient had no complaint and ejection fraction were still normal. Our case emphasizes that the troponin levels predict neither the early nor the late outcome of the left ventricular functions in myocarditis, therefore serum troponin I may not be helpful in determining the prognosis of patients with myocarditis.
基金This project was enlisted as one item of the National Ninth 5-Year Projects (No. 96-90602-13)
文摘Objective: To evaluate the clinical efficacy of Shengmai Powder (SMP, 生脉散) in treating a-cute viral myocarditis objectively. Methods: One hundred and twenty-four patients with acute viral myocarditis were randomized into the treated group (SMG, n = 64) and the control group(CG, n = 60 ). Such myo-cardial nutrient medicine as ATP, CoA , Vit-C, were given to both groups. And to the treated group, 40 ml of Shengmai Injection per day was given intravenously for 2 weeks, which was followed by oral intake of Shengmai granule, one package three times daily for another 2 weeks in total. The same anti-arrhythmia agents were applied to both groups, and no fructose-1, 6-diphosphate (FDP) for either. Semi-quantitative scoring method was adopted to observe such symptoms as chest stuffiness, palpitation and chest pain before treatment and four weeks after treatment. Meanwhile, EGG, dynamic ECG by Holter monitor, left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), serum neutralizing antibody of virus Coxsackie B, cardiac troponin I (cTnl) and cardiac troponin T (cTnT) were examined. Results: (1) Compared with the control group, more significant improvement was got in SMG in respects of chest stuffiness, palpitation, chest pain and arrhythmia (P<0.05 or P<0.01). (2) Negative converting rates of cTnl ,cTnT in the two groups were 59.46% vs35.48%, 68.75% vs42.31% respectively ( P<0. 05). (3) LVEDD before and after treatment in SMG was 52. 44 ± 3. 40 mm and 48. 81 ± 2. 23mm respectively, while that in the control group was 52. 31 ± 3. 74 mm and 49. 92 ± 2. 67mm respectively; LVEF before and after treatment in SMG was 60.67 ± 4. 62 % and 65. 02 ± 4. 16 % respectively, while that in the control group was 60.91 ± 4. 26 % and 63. 67 ± 3.17 % . There was obvious improvement in the two parameters in both groups, but the improvement in SMG was superior to that in the control group ( P<0. 05). Conclusion: SMP shows a good effect in improving clinical symptoms and signs, heart function, abnormal ECG and inflammatory injury indexes in patients with acute viral myocarditis.
