Acquired Heart Diseases

Infective Endocarditis

The smooth inner layer of the heart and the valves is called the endocardium. Infection and inflammation of the valves and this layer of the heart is called infective endocarditis.

What causes Infective Endocarditis?

This is usually caused by bacteria. Some fungi and other microorganisms are also known to cause endocarditis.

Bacteria are not normally found in the blood but may enter the bloodstream during dental or surgical procedures.

There are two types of endocarditis: acute and subacute endocarditis.

In acute endocarditis an aggressive strain of bacteria enters the bloodstream and the diease progresses rapidly. Normal heart valves are attacked and the infection spreads through the bloodstream to other organs like the lungs, kidneys and brain. If untreated this can be fatal within six weeks.

Subacute endocarditis progresses slowly. However, prompt treatment is required. It tends to attack the already affected valves.

Who is at risk?

People in the following category at risk:

• Those who have had rheumatic fever/rheumatic heart disease
• Those who have undergone invasive procedures like cardiac catheterisation
• Those who have artificial heart valves
• Those who have other cardiac complications.
• In some susceptible people minor surgical procedures like dental procedures increase the risk of endocarditis.

The Symptoms

• Fevers
• Chills
• Night Sweats
• Joint pain
• Breathlessness
• Irregular heart beat.

Diagnosis

The patient may be required to undergo the following tests:

• Blood tests
• ECG
• X Ray
• Echo Cardiogram

Treatment

The patient has to be hospitalised. Antibiotics may be prescribed for six weeks.

The patient is advised bed rest. If valves have been damaged surgical replacement of valves may be necessary.

Myocarditis

Myocarditis is the inflammation of the middle layer of the heart muscle. This is a fairly rare heart condition. There are many types of infection that may cause this condition, but the most common cause is viral infection. Medication, chemical contamination, environmental toxins, radiation therapy, pregnancy-related factors etc have been associated with myocarditis

Symptoms

Some of the symptoms patients may exhibit are:

• Fever,
• Chest Pain
• Irregular heartbeat
• Breathlessness
• Fatigue

Diagnosis

The following diagnostic tests may be advised:

• Physical exam
• Blood tests
• ECG
• Chest X ray

Treatment

In cases of mild myocarditis, rest and medication may be enough.

When myocarditis is serious enough to produce heart failure or irregular heartbeat oxygen supply, pacemaker, intravenal antibiotics etc may be used to treat the patient.

Pericarditis

Pericarditis is an inflammation of the pericardium, the uppermost layer that surrounds the heart. Pericarditis may be caused by a virus or bacterial infection, such as tuberculosis.

Symptoms

Common symptoms of pericarditis are:

• Chest pain radiating to the left side of the neck, shoulder, back or abdomen.
• Breathlessness
• Fever
• Pain while swallowing

Diagnosis

The following diagnostic tests may be advised:

• Physical exam
• Blood tests
• ECG
• Chest X ray

Treatment

Treatment of Pericarditis depends on the cause. If it has been caused by a bacterial infection antibiotics are prescribed. Analgesics or anti-inflammatory drugs can be given to relieve pain.

Sometimes fluid collects in the space between pericardium and the heart. This excess fluid may need to be drained through a catheter. In some cases, surgery may be required.