Inflammatory Heart Disease

Inflammatory heart disease develops when the surrounding heart tissue or muscle is subjected to inflammation from exposure to an infection like a bacteria or virus or from an internal irregularity. This type of inflammation may occur in cases of rheumatic fever and kawasaki disease. The condition may be categorized as either endocarditis, myocarditis or pericarditis.

Pericarditis

The heart is enclosed by a sac called the pericardium. The sac is comprised of two layers the fibrous pericardium and the serous pericardium. The serous pericardium consists of two layers which both provide lubrication to the active heart to eliminate friction. The fibrous pericardium is the outer layer of dense connective tissue that secures the heart to the bordering walls, prevents the excessive flooding of the heart with blood and protects the heart.

There are many instances where pericarditis occurs without a known cause however there are some triggers that have been identified including:

• Viral and bacterial infections
• Connective tissue disease such as sarcoidosis and rheumatoid arthritis
• Previous injury to the heart like heart attack, trauma and heart surgery
• Metabolic disorders most notably hypothyroidism and uremia (kidney failure)
• An adverse reaction to a specific type of medication
• Tumours and cancers

Symptoms

• The primary symptom will be chest pain that is usually described as a sharp severe pain that may radiate from the chest area to the shoulder blades, neck and back. There may also be pain near the diaphragm that migrates to the back area. Upon deep inhalation the chest pain will likely be exacerbated. It is also much worse when lying down and generally alleviated by slanting the body forward.
• Pain may manifest upon swallowing if the inflammation is very close to the oesophagus.
• It is also possible to experience a fever if the pericarditis is triggered by an infection.

Diagnosing Pericarditis

To diagnose the disease the doctor will assess the type of pain being experienced by the patient. The most obvious finding may be from a pericardial friction rub which is basically a sound that will be heard when a stethoscope is applied to the chest area. However this is not always guaranteed to work because the rub is not constant.

To ensure an accurate diagnosis an ECG electrocardiogram, chest x-ray and ultrasound of the heart will be performed.

A blood test may be performed to identify any other underlying conditions that may have prompted the pericarditis.

Treatments

The foremost treatment is the administering of anti-inflammatory medications. Drugs like ibuprofen are used to decrease the inflammation. A pain reliever in the form of a narcotic pain medication may be prescribed. Pericardiocentesis may be performed to remove excess fluid from the sac or it may be used to identify the pathogen of origin that may have initiated the condition.

Endocarditis

Endocarditis is caused by an infection of the endocardium or inner lining of the heart resulting in subsequent inflammation. It generally manifests when pathogens from other areas of the body enter the bloodstream and latches on to weakened areas of the heart. If is not treated it may partially or completely ruin the heart valves and may also progress into a life- threatening condition. The condition rarely affects individuals with healthy hearts. The greatest risk factor is having a damaged or artificial heart valve or any other heart defect.

Symptoms

The development of endocarditis may be quite sudden or may be gradual in progression dependent on the particular type of infection or associated heart defect.

• Joint and muscle pain
• Fever and chills
• Heart murmurs (irregular sounds emanating from the heart)
• Persistent coughing
• Oedema (swelling) of the feet and abdomen
• Extreme tiredness or fatigue
• Night sweats
• Tenderness below the rib cage generating from the spleen
• A pale complexion
• Blood in the urine
• Visible purple or red spots in the mouth on the skin or on the whites of the eyes
• Areas of red tender spots beneath the skin of the fingers.
• Sudden weight loss
• Shortness of breath

Though these symptoms may resemble other non-critical conditions it is still important to contact a doctor once a few of these symptoms are experienced especially in the presence of another heart condition.

High risk groups for developing the condition

• Individuals with artificial valves. Artificial valves are more likely to be attacked by pathogens especially within the first year of implantation of the valve.
• Having a congenital birth defect means the heart is more prone to infection.
• Experiencing any prior damage to the heart valve will make developing the condition more likely.
• Intravenous drug users have a heightened chance of developing the condition because the needles that are shared are likely to be contaminated with bacteria that can trigger infection leading to this disease.

Diagnosis

• Blood tests will be performed to identify the source of bacterial infection.
• An echocardiogram will be used so that the doctor can assess any damages to the valve.
• An ECG or electrocardiogram and x-ray will be used to further assess the hearts condition.
• If the infection is thought to have affected other areas of the body a CT computerized tomography or MRI magnetic resonance imaging scan will be performed.

Treatments

Treatment will often include antibiotics in less severe cases and surgery in instances where there is valve damage or persistent infection.

Myocarditis

Myocarditis refers to inflammation of the heart muscle. It is caused by several infections including viruses like sarcoidosis, pregnancy, and immune diseases. The most frequent form of infection is by a virus which will attack the heart muscle producing local inflammation. Once the infection is abated the immune response will be perpetuated, lengthening the duration of the myocarditis.

Symptoms

It may sometimes be asymptomatic. The most typical system is pain in the chest. In severe cases the disease may result in deterioration of the heart muscle. It is therefore possible for it to cause heart failure with evident shortness of breath or difficulty breathing, oedema, extreme tiredness and so on.

Diagnosis

It will be identified by using the conventional methods of diagnostics. ECG or electrocardiogram will be used to pinpoint irregularities within the heartbeat. MRI or magnetic resonance imaging tests will be used to detect heart muscle abnormalities. Blood tests will be carried out to check for infection and possible elevation of heart muscle enzymes.

Prognosis

It is not known from the outset of the disease how well an individual will recover. Some persons recover completely while others may develop chronic heart failure due to excessive damage to the heart muscles. Rarely an individual may be afflicted with fulminant heart failure which is lethal if a heart transplant is not performed. If the damage to the muscle is extreme a defibrillator may be implanted to increase the heart’s overall efficiency.