MỐI LIÊN QUAN GIỮA TRIỆU CHỨNG LÂM SÀNG VÀ CẬN LÂM SÀNG VỚI RỐI LOẠN NHỊP TIM Ở BỆNH NHÂN VIÊM CƠ TIM CẤP

Abstract

Myocarditis is a condition with diverse clinical presentations, ranging from asymptomatic cases to critical scenarios such as acute heart failure, arrhythmias, and even death. Arrhythmias often appear with varying severity. Notably, malignant arrhythmias are the leading cause of death in the acute phase for most patients. Objective: To investigate the correlation between clinical symptoms, paraclinical findings and arrhythmias in patients with acute myocarditis. Subjects and Methods: A cross-sectional study was conducted on 51 patients with acute myocarditis treated at the Intensive Care Unit and the National Heart Institute - Bach Mai Hospital from July 2018 to July 2019. Patients underwent examinations, laboratory tests, and 24-48 hour Holter electrocardiogram monitoring. Results: The average age was 36 ± 16 years, with male patients accounting for 41.2%. Malignant arrhythmias were observed in 66.7% of patients, and 39.2% had three or more episodes of arrhythmias. Factors associated with the severity and frequency of arrhythmias included dyspnea, blood pressure, urine output, potassium levels, CK-MB levels, Troponin T levels, NT-proBNP levels, ejection fraction, and the necessity for ECMO support. Among these, 24-hour urine output, CK-MB levels, Troponin T levels, and the need for ECMO treatment were independently associated. Conclusion: Patients with myocarditis exhibit a high incidence of complex arrhythmias. Clinical and paraclinical factors are closely related to the occurrence of these arrhythmias.