Inflammation and Your Heart: Endocarditis, Pericarditis and Myocarditis
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Inflammation and your heart: Endocarditis, pericarditis and myocarditis Types of inflammation Myocarditis When you see the letters ‘itis’ at the end of a What causes myocarditis? Will I need treatment? word, it means inflammation. Myocarditis is inflammation of the myocardium Myocarditis is often mild and goes unnoticed, but – the heart muscle. It is usually caused by a viral, you may need to take medicines to relieve your Myocarditis, pericarditis and bacterial or fungal infection. Sometimes the cause is symptoms such as non-steroidal anti-inflammatories endocarditis refer to inflammation unknown – or ‘idiopathic’. and sometimes antibiotics. around or in the heart. If the myocarditis it is causing a problem with What are the symptoms? how well your heart pumps, you may develop the • Myocarditis – inflammation of the myocardium The symptoms of myocarditis usually include a (the heart muscle) symptoms of heart failure which you will need to pain or tightness in your chest which can spread to take several different types of medicines for. In very • Pericarditis – inflammation of the pericardium other parts of your body, shortness of breath and extreme cases where there is severe damage to the (the sac which surrounds tiredness. You may also have flu like symptoms, such heart you may be considered for a heart transplant. the heart) as a high temperature, feeling tired, headaches and aching muscles and joints. • Endocarditis – inflammation of the Inflammation of the heart often causes chest pain, endocardium (the inner lining of the heart) What tests will I need? and you may feel like you are having a heart attack. If you have not been diagnosed with one of You may need to have an electrocardiogram (ECG), these conditions and you have chest pain, or any echocardiogram (a scan of your heart similar to an of the symptoms we describe below, call 999 ultrasound) and various blood tests. immediately. Pericarditis Endocarditis What causes pericarditis? What tests will I need? What causes endocarditis? Pericarditis is inflammation of the pericardium – If your doctor thinks you have pericarditis you will Endocarditis is a rare condition where the inner the protective sac that surrounds your heart. The usually be sent to have an echocardiogram (similar lining of the heart – most commonly one of the heart pericardium has an inner and outer layer, and can to an ultrasound), which can check for any fluid valves – becomes infected. It is caused by a certain become inflamed if blood or fluid leak between the between the two layers of the pericardium. You type of bacteria, or in some rare cases another two layers or the sac itself is damaged. may also need to have an electrocardiogram (ECG), type of infective organism, which enters into your a chest X-ray, various blood tests and an MRI or CT bloodstream and travels to your heart. Endocarditis This can happen because: scan or your chest. can be life-threatening if not treated quickly. • You have recently had a heart attack or heart surgery. Will I need treatment? What are the symptoms? You may be given medicines to relieve your The symptoms of endocarditis can be very subtle • You have a virus or bacterial infection symptoms, such as non-steroidal anti-inflammatories and non-specific, developing slowly over a few (such as the flu). to reduce both the pain and inflammation. You weeks or sometimes months. Or they can develop • You have another inflammatory condition may also need to take other painkillers, aspirin and very quickly. (such as rheumatoid arthritis). corticosteroids (steroids) and your symptoms should • You have kidney failure, or rarely some forms start to settle within a few weeks. The most common symptoms are: of cancer. If you have a large amount of fluid in your pericardial • Flu like symptoms with a high temperature Sometimes the cause is unknown – or ‘idiopathic’. sac, you may need to have a treatment called – these include tiredness, headaches, aching pericardiocentesis, or a ‘pericardial tap’. This involves muscles and joints, a cough and sore throat. inserting a thin tube through the chest wall to drain • Weight loss. What are the symptoms? the fluid, and is carried out under a local anesthetic. The symptoms are very similar to those of angina, If the fluid keeps returning, you may need to have an • A heart murmur (an abnormal heart sound that and you may feel like you are having a heart attack. operation – called a ‘pericardial window’ – to try and can be heard when listening to your heart with You will usually feel a sharp and stabbing pain in stop the fluid collecting. a stethoscope). your chest. It can also feel tight and crushing, and If you have been told you are at high risk of getting spread to your arms, neck, jaw, back or stomach. What is constrictive pericarditis? endocarditis and you have flu-like symptoms with The pain in your chest may worsen if you take a deep Constrictive pericarditis is a rare condition in which a high temperature for longer than a week, you breath in or when you lay flat, and ease if you sit the pericardium becomes thickened and rigid, and should see your GP. upright or lean forward. You may also feel short of scar tissue forms. It can happen if you have a long- breath, sick, sweaty and light-headed. Or you may term infection, such as tuberculosis, but often the just feel generally unwell and ‘not quite right’. cause is unknown. ©British Heart Foundation 2014, a registered charity in England & Wales (225971) and Scotland (SC039426).