Heart Infections

 The term heart infection may be used to describe conditions such as endocarditis or myocarditis. Symptoms of a heart infection include:

• chest pain
• chest congestion or coughing
• fever
• chills
• skin rash

What is endocarditis?

Endocarditis is inflammation of our heart’s inner lining, called the endocardium. It’s usually caused by bacteria. When the inflammation is caused by infection, the condition is called infective endocarditis. Endocarditis is uncommon in people with healthy hearts.

Symptoms of endocarditis

The symptoms of endocarditis aren’t always severe, and they may develop slowly over time. In the early stages of endocarditis, the symptoms are similar to many other illnesses. This is why many cases go undiagnosed.

 

Many of the symptoms are similar to cases of the flu or other infections, such as pneumonia. However, some people experience severe symptoms that appear suddenly. These symptoms may be due to inflammation or the associated damage it causes.

Common symptoms of endocarditis include:

• heart murmur, which is an abnormal heart sound of turbulent blood flow through the heart
• pale skin
• fever or chills
• night sweats
• muscle or joint pain
• nausea or decreased appetite
• a full feeling in the upper left part of your abdomen
• unintentional weight loss
• swollen feet, legs, or abdomen
• cough or shortness of breath

Less common symptoms of endocarditis include:

• blood in your urine
• weight loss
• an enlarged spleen, which may be tender to touch

Changes in the skin may also occur, including:

• tender red or purple spots below the skin of fingers or toes
• tiny red or purple spots from blood cells that leaked out of ruptured capillary vessels, which usually appear on the whites of the eyes, inside the cheeks, on the roof of the mouth, or on the chest

 

The signs and symptoms of infectious endocarditis vary greatly from person to person. They can change over time, and they depend on the cause of your infection, heart health, and how long the infection has been present. If you have a history of heart problems, heart surgery, or prior endocarditis, you should contact your doctor immediately if you have any of these symptoms. It’s especially important to contact your doctor if you have a constant fever that will not break or you’re unusually tired and don’t know why.

 

Causes of endocarditis

The main cause of endocarditis is an overgrowth of bacteria. Although these bacteria normally live on the inside or outside surfaces of our body, we might bring them inside to our bloodstream by eating or drinking.

 

Bacteria could also enter through cuts in our skin or oral cavity. Our immune system normally fights off germs before they cause a problem, but this process fails in some people.

 

In the case of infective endocarditis, the germs travel through your bloodstream and into your heart, where they multiply and cause inflammation. Endocarditis can also be caused by fungi or other germs.

 

Eating and drinking aren’t the only ways that germs can enter our body. They can also get into our bloodstream through:

 

• brushing our teeth
• having poor oral hygiene or gum disease
• having a dental procedure that cuts our gums
• contracting a sexually transmitted disease
• using a contaminated needle
• through an indwelling urinary catheter or intravenous catheter

What is myocarditis?

Myocarditis is a disease marked by the inflammation of the heart muscle known as the myocardium — the muscular layer of the heart wall. This muscle is responsible for contracting and relaxing to pump blood in and out of the heart and to the rest of the body.

 

When this muscle becomes inflamed, its ability to pump blood becomes less effective. This causes problems like an abnormal heartbeat, chest pain, or trouble breathing. In extreme cases, it can cause blood clots leading to a heart attack or stroke, damage to the heart with heart failure, or death.

 

Normally, inflammation is a bodily response to any sort of wound or infection. Imagine when you cut your finger: within a short time, the tissue around the cut swells up and turns red, which are classic signs of inflammation. The immune system in our body is producing special cells to rush to the site of the wound and implement repairs.

 

But sometimes the immune system or another cause of inflammation leads to myocarditis.

 

Causes myocarditis

In most of the cases, the exact cause of myocarditis is not found. When the cause of myocarditis is found, it’s usually an infection that has made its way to the heart muscle, such as a viral infection (the most common) or a bacterial, parasitic, or fungal infection.

 

As the infection tries to take hold, the immune system fights back, trying to get rid of the disease. This results in an inflammatory response that may weaken heart muscle tissue. Some autoimmune diseases, like lupus (SLE), can cause the immune system to turn against the heart, resulting in inflammation and myocardial damage.

 

It’s often difficult to determine exactly what’s causing the myocarditis, but potential culprits include the following causes.

 

Viruses

Viruses are one of the most common causes of infectious myocarditis. The most common viruses to cause myocarditis include Coxsackievirus group B (an enterovirus), Human Herpes Virus 6, and Parvovirus B19 (which causes fifth disease).

 

Other possibilities include echoviruses (known to cause gastrointestinal infection), Epstein-Barr virus (causes infectious mononucleosis), and Rubella virus (causes German measles).

 

Bacteria

Myocarditis can also result from infection with Staphylococcus aureus or Corynebacterium diptheriae. Staphylococcus aureus is the bacterium that can cause impetigo and be a methicillin resistant strain (MRSA). Corynebacterium diptheriae is the bacterium that causes diphtheria, an acute infection that destroys tonsils and throat cells.

 

Fungi

Yeast infections, molds, and other fungi can sometimes cause myocarditis.

Parasites

Parasites are microorganisms that live off of other organisms to survive. They can also cause myocarditis. This is rare in the society but more commonly seen in Central and South America (where the parasite Trypanosoma cruzi causes a condition known as Chagas disease).

 

Autoimmune diseases

Autoimmune diseases that cause inflammation in other parts of the body, like rheumatoid arthritis or SLE, can also sometimes cause myocarditis.

 

Symptoms of Myocarditis

The dangerous thing about myocarditis is that it can affect anyone, occur at any age, and may proceed without displaying any symptoms.

 

If symptoms do develop, they often resemble those symptoms one might experience with the flu, such as:

• fatigue
• shortness of breath
• fever
• joint pain
• lower extremity swelling
• achy feeling in the chest

Many times, myocarditis may subside on its own without treatment, much like a cut on your finger eventually heals. Even some cases that go on for a long time may never create sudden symptoms of heart failure.

 

But, secretly, they may cause damage to the heart muscle where the heart failure symptoms slowly appear over time. In other instances, the heart may be faster at revealing its struggles, with symptoms like chest pain, shortness of breath, heart palpitations, and heart failure.