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Hartontsteking (endocarditis)

  • Article
  • 2021-02-01

Also known as endocarditis, myocarditis, pericarditis
Inflammation is your body's response to infection or injury. It can affect many parts of the body and is a cause of many important diseases, including cancer, ischemic heart disease and autoimmune diseases. Inflammation in the heart causes damage and can lead to serious health problems.

There are three main types of heart inflammation: endocarditis, myocarditis, and pericarditis. Endocarditis is inflammation of the lining of the heart chambers and valves. Myocarditis is inflammation of the heart muscle. Pericarditis is inflammation of the tissue that forms a sac around the heart. Many things cause heart inflammation. Common causes include viral or bacterial infections and medical conditions that damage the heart and cause inflammation.

You can have different signs and symptoms, depending on the type and severity of the heart infection you have. The treatment your doctor recommends may depend on whether you have been diagnosed with inflammation of the lining of your heart or valves, the heart muscle, or the tissue surrounding the heart. You can be treated with medications, procedures, or possibly surgery to treat your condition and its complications. Complications can include an arrhythmia or an irregular heartbeat and heart failure.

Symptoms

If a virus is causing your heart infection, you may experience a cough, runny nose, or gastrointestinal symptoms for a few weeks before your heart infection symptoms. The signs and symptoms of heart infection are different, depending on the type of heart infection you have.

Endocarditis

  • Fever and chills
  • New or worsening heart murmur
  • Blood in the urine
  • Spleen that is larger than normal
  • Stomach ache
  • Chestpain
  • Cough, with or without the presence of blood
  • Loss of appetite and weight loss
  • Muscle, joint and back pain
  • Night sweats
  • Pain where an infected heart device is located
  • Shortness of breath
  • Skin changes, which can occur with endocarditis. These can be painful red or purple bumps, or painless flat red spots on areas such as the palms of the hands or soles of the feet, or small reddish-purple spots from broken blood vessels.

Myocarditis

  • Chest pain and discomfort
  • Palpitations
  • Pass out
  • Shortness of breath
  • Fatigue
  • Stomach ache
  • Exercise intolerance, or no longer being able to exercise
  • Fever
  • Loss of appetite
  • Swelling of the feet or legs
  • Weakness

Pericarditis

  • Chestpain. Chest pain from pericarditis usually feels sharp, gets worse when breathing, and feels better when sitting and leaning forward.
  • Rapid heartbeat
  • Fever
  • Shortness of breath

Therapy

If you are diagnosed with heart inflammation, such as endocarditis, myocarditis, or pericarditis, your doctor may recommend medication or surgery to treat your condition. Mild cases of myocarditis and pericarditis may resolve without treatment.

Medicines

Your doctor may prescribe one or more medicines to treat heart inflammation, depending on the type and cause of heart infection.

Endocarditis

  • Antibiotics to treat bacterial infections. Side effects from antibiotics depend on the antibiotic being used, but may include diarrhea; problems with hearing, balance and kidneys; and a reduced number of white blood cells. Some of these side effects may not occur until treatment is complete.
  • Antifungals to treat fungal infections. Sometimes your doctor may recommend a lifetime oral antifungal treatment to keep the infection from returning. Possible side effectsSome of the antifungals are allergic reactions, such as diarrhea, dizziness, itching, blistering or hives, difficulty breathing, weight loss and jaundice.
  • Blood thinners to treat some types of endocarditis

Myocarditis

  • Corticosteroids to decrease the activity of the body's immune system. Corticosteroids can be used to treat myocarditis caused by autoimmune diseases, such as lupus.
  • Heart failure medications to decrease the work of the heart when heart failure is a complication. Your doctor may recommend medications such as beta blockers and angiotensin converting enzyme (ACE) inhibitors.
  • Intravenous Immunoglobulin (IVIG) helps control the body's immune and inflammatory response.

Pericarditis

  • Anti-inflammatory drugs to treat pericarditis. These include colchicine, aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and indomethacin. Side effects are mainly gastrointestinal and include abdominal pain, nausea, vomiting and diarrhea.
  • Corticosteroids to decrease the activity of the body's immune system. In pericarditis, corticosteroids are used only in patients who do not respond to or cannot use NSAIDs.
  • Intravenous Immunoglobulin (IVIG) to help control the body's immune and inflammatory response. This can be used if there is an autoimmune disease such as lupus.

Procedures

Your doctor may consider procedures and surgeries to treat your heart infection, including:

  • Heart surgery to control damage to valves or nearby heart tissue from endocarditis. This may involve removal of infected tissues or reconstruction of the heart, including repairing or replacing the affected valve.
  • Pericardiocentesis to remove excess fluid in the pericardium, called a pericardial effusion

Healthy lifestyle changes

Your doctor may recommend lifestyle changes depending on the cause of your heart infection. These recommendations could include:

  • Avoiding amphetamines, cocaine, or IV drugs
  • Maintain good oral hygiene


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