Clinical and Morphological Features of Myocardial Damage and the Course of Fulminant Myocarditis on the Background of СOVID-19, Diagnosis and Treatment Tactics

• DOI: 10.15690/vramn1433
• Publication Date: 2020-12-21T11:16:24Z
• Authors: Olga S. Oynotkinova; Evgenii L. Nikonov; Oleg V. Zayratyants; Elena V. Rzhevskaya; Evgenii V. Krukov; Michail I. Voevoda; Olga M. Maslennikova; Vera N. Larina; Tatiana Y. Demidova; Evgenii I. Dedov
• Keywords: Fulminant; Cytokine Storm; Pathogenesis

In a review article based on my own clinical experience of managing patients with acute myocardial injury and fulminant myocarditis, taking into account expert recommendations the treatment damage associated novel coronavirus infection National geriatric medical research center, division cardiovascular diseases, Chinese geriatrics society, Department cardiology, Beijing Medical Association European clinics discusses pathogenesis, diagnosis FM patients, infected SARS-CoV-2 in context COVID-19 pandemic. Clinical features diagnostic criteria are presented, including screening tests markers form highly sensitive troponin test, natriuretic peptide. The detail pathogenesis mechanisms damage, immune mechanisms, cytokine storm, systemic inflammation macro- microvascular dysfunction development heart failure, hypotension, cardiogenic shock and/or life-threatening rhythm disorders caused by hypoxia metabolic at cellular level. Features course myocarditis (SARS-CoV-2) conditions pandemic presented. For first time, detailed histo-morphological analysis pathological injuries complications is presented basis unique autopsy material post-mortem diagnostics various pathoanatomic autopsies those who died from Moscow. Based clinical, functional morphological material, Protocol etiopathogenetic standard therapy considered antiviral drugs, immunoglobulin G, use monoclonal antibodies to interleukin-6, anticoagulants, glucocorticoids, depending situation, cardioprotectors symptomatic recommended maintain heart, which combination can achieve certain effectiveness. As adjuvant cardioprotective targeted therapy, sodium salt phosphocreatine order preserve myocardium, its contractility vital activity.