Apical Diffusion

Introduction In myocarditis, in addition to the weakening of the apex, the apex is often accompanied by pulsation. Myocarditis is a localized or diffuse inflammation of the heart muscle that can occur primarily in the heart muscle or as part of a systemic disease.

Cause

The cause is infection, physical and chemical factors, drugs, etc. The most common is viral myocarditis, which is most commonly seen with enteroviruses, especially Coxsackie B virus.

an examination

Related inspection

ECG heart sound map check intracardiac electrophysiological examination

Fatigue, fever, chest tightness, palpitations, shortness of breath, dizziness, severe heart failure or cardiogenic shock. The heart rate increases, which is not proportional to the increase in body temperature, the heart is enlarged, the noise is changed, and the arrhythmia is abnormal.

Differential diagnosis

Differential diagnosis of apical beat diffusion:

Increased apical beat: When the left ventricle is hypertrophied, the apex beats are enhanced and the range is large. If the apex beats strong and powerful, when the finger is used for palpation, the fingertip can be lifted for a moment, called the lifted apex beat, which is a reliable sign of obvious hypertrophy of the left ventricle.

The apex beats weakened or even disappeared: in the case of pericardial effusion, left pneumothorax or pleural effusion, emphysema, etc., the apex beat weakened or even disappeared. In myocarditis, in addition to the weakening of the apex, the apex is often accompanied by pulsation. In the case of a large amount of pericardial effusion, not only the apex beat is weakened, but also inconsistent with the apical voiced boundary, and the apex beat is located inside the heart sounding boundary.

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