Inflammatory Heart Disease
Most types of inflammatory heart disease are caused by bacterial infections. More rarely, fungi or viruses can cause this type of inflammation.This type of heart disease is distinct from cardiovascular diseases in that high blood pressure, high cholesterol, and other such conditions are not risk factors for the disease.
Infection or inflammation of the heart can affect three main parts of the organ: the myocardium, the endocardium, or the pericardium. Inflammation can also affect the heart valves.
Endocarditis is an inflammation of the endocardium of the heart, which includes the interior lining of the chambers and valves of the organ. This heart inflammation often causes valvular heart disease. Endocarditis is usually caused by bacterial or fungal infection.
There are several risk factors for this disease, including intravenous drug use, weakened heart valves, prior heart valve surgery, and recent dental surgery. Someone with a permanent venal access line also has an increased risk of endocarditis.
Symptoms of endocarditis include fatigue, sweating, chills, muscle and joint aches and pains, pale skin, discoloration or pain in fingers and toes, shortness of breath, swelling of the legs and feet, and weight loss. These symptoms can develop slowly or might be of sudden onset.
Treatment for endocarditis includes initial administration of intravenous antibiotics to curb the infection, followed by up to six weeks of further antibiotic treatment. Surgery might be needed to replace a damaged heart valve.
Myocarditis is an infection or inflammation of the heart muscle itself, called the myocardium. Myocarditis is relatively rare, and is usually caused by a bacterial, fungal, or viral infection. Other causes include allergic reactions, chemical exposure, and inflammatory diseases such as rheumatoid arthritis.
Some people with myocarditis have no recognizable symptoms. When symptoms are experienced they can include chest pain, heart arrhythmia, fatigue, fever, pain or swelling in joints, swollen legs and feet, and shortness of breath. Some people might have reduced urine output, and might have episodes of fainting.
Treatment for myocarditis includes antibiotics to control infection, as well as anti-inflammatory medication to reduce swelling in the heart. Additional medication might include diuretics to help remove retained fluid. A low salt diet, combined with reduced physical activity, might also be prescribed.
Depending on the extent of the heart damage, some people completely recover from myocarditis, while others might develop heart failure that requires ongoing treatment.
The pericardium is a membranous sac that surrounds the heart. In pericarditis, this sac becomes inflamed or infected. The most common cause of this disease is infection with a virus or bacteria. Pericarditis can also develop after a heart attack or other heart injury, in conjunction with myocarditis, or after chest radiation therapy.
Common symptoms of pericarditis include dry cough, fever, fatigue, difficulty breathing, and anxiety. Some people have swelling of the legs, feet, and ankles. Another symptom is chest pain that radiates to the back, shoulders, abdomen, or neck. Often the pain is worse when breathing deeply, or when lying on the back. For some people, the pain is a sharp stabbing type of pain called pleuritis.
Treatment of pericarditis first includes antibiotics, antivirals, or antifungal medications to control the organism causing the infection. Analgesics and anti-inflammatories to reduce pain and inflammation, and diuretics to remove excess water, might also be prescribed. When inflammation is very severe, a short course of corticosteroids might be needed.
In cases of chronic or recurrent pericarditis, surgery might be required. The procedure most often used involves removing a section of the pericardium.
John L Brusch, MD, FACP for eMedicine: Infective Endocarditis
National Institute of Health MedlinePlus: Endocarditis
National Institute of Health MedlinePlus: Myocarditis
National Institute of Health MedlinePlus: Pericarditis
Sean Spangler, MD for eMedicine: Acute Pericarditis
Wai Hong Wilson Tang, MD for eMedicine: Myocarditis