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Myokarditis

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SpringerReference Innere Medizin

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Zusammenfassung

Myokarditiden sind entzündliche Erkrankungen des Herzmuskels mit infektiösen und nicht infektiösen Ursachen. Eine Myokarditis kann Folge einer nicht ausgeheilten viralen oder sonstigen Infektion oder autoimmun, autoentzündlich, toxisch oder allergisch bedingt sein. Der spezifische Erreger- und/oder Entzündungsnachweis erfolgt durch direkte Gewebeanalyse nach Myokardbiopsie. Plötzlich einsetzende atypische Angina pectoris und zunächst vorwiegend bei Belastung auftretende Dyspnoe weisen neben Rhythmusstörungen, einem Perikarderguss sowie einer progredienten Herzinsuffizienzsymptomatik auf einen akuten Entzündungsprozess des Myokards hin. Daneben können sich auch uncharakteristische Beschwerden wie Abgeschlagenheit, Müdigkeit und körperliche Leistungseinschränkungen zeigen. Zur Diagnose gehören insbesondere EKG und Bestimmung der CK-, CK-MB- und/oder Troponin-T/I-Werte. Ergänzend kommen Röntgen-Thorax, Echokardiographie, MRT, Koronarangiographie,sowie eine Myokardbiopsie mit histologischer/immunhistochemischer Entzündungsdiagnostik und einer molekularbiologischen Virusdiagnostik zur Anwendung. Die Behandlung einer Herzinsuffizienz oder ventrikulärer Rhythmusstörungen erfolgt immer symptomatisch nach allgemeinen evidenzbasierten Richtlinien. In schweren Fällen ist eine Assist-Anlage, ggf. auch eine Herztransplantation erforderlich. Subgruppen von Patienten können erfolgreich immunsuppressiv oder antiviral behandelt werden, wenn Virusinfektionen oder Entz€undungsprozesse myokardbioptisch nachgewiesen wurden und noch keine irreversiblen Myokardschðden vorliegen.

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Authors and Affiliations

  1. Kardiologie und Pneumonologie, Medizinische Klinik II, Charité ? Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Deutschland

    Uwe Kühl & Heinz-Peter Schultheiss

Authors
  1. Uwe Kühl
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  2. Heinz-Peter Schultheiss
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Corresponding authors

Correspondence to Uwe Kühl or Heinz-Peter Schultheiss .

Editor information

Editors and Affiliations

  1. Medizinische Klinik I, Universitätsklinikum Schleswig-Hoslstein, Campus Lübeck, Lübeck, Schleswig-Holstein, Germany

    Hendrik Lehnert

  2. TU Dresden Universitätsklinikum Carl Gustav Carus, Dresden, Germany

    Sebastian M. Schellong

  3. FB Gastroenterologie und Hepatologie, Universitätsklinikum Leipzig Medizinische Klinik und Poliklinik II, Leipzig, Sachsen, Germany

    Joachim Mössner

  4. Krankenhaus Barmherzige Brüder, Regensburg, Germany

    Cornel C. Sieber

  5. Nürnberg, Bayern, Germany

    Walter Swoboda

  6. Universitätsklinikum Giessen und Marburg Klinik für Innere Medizin, Marburg, Hessen, Germany

    Andreas Neubauer

  7. Interdisziplinärer Schwerpunkt für Hämos, Universitätsklinikum Gießen und Marburg, Gießen, Germany

    Bettina Kemkes-Matthes

  8. Klinik für Gastroenterologie,Hepatologie, Medizinische Hochschule Hannover, Hannover, Germany

    Michael P. Manns

  9. Sektion für Molekulare und Klinische Inf, Universitätsklinikum Schleswig-Holstein,, Lübeck, Germany

    Jan Rupp

  10. Abt. Kardiologie und Pneumologie, Universitätsklinikum Göttingen Herzzentrum Göttingen, Göttingen, Germany

    Gerd Hasenfuß

  11. Abt. Nephrologie und Klinische Immunologie, Univ.Klinikum Aachen Medizinische Klinik II, Aachen, Germany

    J. Floege

  12. Universitätsklinikum Köln Klinik I für Innere Medizin, Köln, Germany

    Michael Hallek

  13. Klinik für Pneumologie, Medizinische Hochschule Hannover (MHH) Zentrum Innere Medizin, Hannover, Germany

    Tobias Welte

  14. Klinik u. Poliklinik für Innere Medizin, Universitätsmedizin Greifswald, Greifswald, Germany

    Markus Lerch

  15. Dr.-Horst-Schmidt-Kliniken GmbH, Wiesbaden, Germany

    Elisabeth Märker-Hermann

  16. Klinische Toxikologie, Giftinformation, Universitätsklinikum Mainz II. Medizinische Klinik und Poliklinik, Mainz, Germany

    Ludwig Sacha Weilemann

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Kühl, U., Schultheiss, HP. (2014). Myokarditis. In: Lehnert, H., et al. SpringerReference Innere Medizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54676-1_198-1

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  • DOI: https://doi.org/10.1007/978-3-642-54676-1_198-1

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  • Online ISBN: 978-3-642-54676-1

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