Carditis: Symptoms, Causes, Treatment

What are the symptoms of carditis?

The symptoms of carditis vary depending on the type (endocarditis, myocarditis, or pericarditis) and the severity of the inflammation. Common symptoms include:

Endocarditis (inflammation of the heart’s inner lining):

• Fever and chills
• Fatigue or weakness
• Heart murmur
• Shortness of breath
• Swelling in the legs, abdomen, or feet
• Chest pain (in severe cases)
• Petechiae (small red or purple spots on the skin)

Myocarditis (inflammation of the heart muscle):

• Chest pain or pressure
• Fatigue or lightheadedness
• Rapid or irregular heartbeats (arrhythmias)
• Shortness of breath, especially during activity or rest
• Swelling in the legs, ankles, or feet
• Fainting (in severe cases)

Pericarditis (inflammation of the heart’s outer lining):

• Sharp, stabbing chest pain (often worsens when lying down or breathing deeply)
• Fever
• Fatigue
• Shortness of breath, especially when reclining
• Heart palpitations
• Pain radiating to the shoulder or neck

If you experience any of these symptoms, especially chest pain or difficulty breathing, seeking medical attention is important to determine the underlying cause and receive appropriate treatment.

What are the causes of carditis?

Carditis can be caused by a variety of factors, depending on the type (endocarditis, myocarditis, or pericarditis). Common causes include:

Endocarditis (inflammation of the heart’s inner lining):

• Bacterial infection: The most common cause, often due to bacteria entering the bloodstream and affecting the heart valves (e.g., from dental procedures, surgeries, or intravenous drug use).
• Fungal infection: Less common, but certain fungi can cause endocarditis.
• Autoimmune diseases: Conditions like lupus can cause non-infectious endocarditis.
• Congenital heart defects: Abnormal heart structures can make individuals more susceptible.

Myocarditis (inflammation of the heart muscle):

• Viral infections: Common causes include viruses like the flu, COVID-19, Coxsackievirus, or hepatitis.
• Bacterial infections: Less common but can result from infections such as Lyme disease or diphtheria.
• Autoimmune diseases: Conditions like lupus or sarcoidosis can cause the body’s immune system to attack heart tissue.
• Medications or drugs: Certain drugs, including chemotherapy, can lead to myocarditis.
• Toxins: Exposure to substances like alcohol, drugs, or heavy metals.

Pericarditis (inflammation of the heart’s outer lining):

• Viral infections: The most frequent cause of pericarditis, often related to respiratory infections.
• Bacterial infections: Less common, but tuberculosis and other bacterial infections can lead to pericarditis.
• Autoimmune diseases: Conditions such as rheumatoid arthritis or lupus.
• Heart attack: Pericarditis can occur after a heart attack (called Dressler’s syndrome).
• Chest trauma or surgery: Injury to the heart or chest can cause inflammation.
• Cancer or cancer treatments: Radiation therapy and cancer spreading to the pericardium can result in pericarditis.

Timely treatment of the underlying cause is crucial to prevent complications.

What is the treatment for carditis?

The treatment for carditis depends on the type (endocarditis, myocarditis, or pericarditis), its severity, and the underlying cause. Here’s a breakdown of common treatments for each type:

Endocarditis (inflammation of the heart’s inner lining):

• Antibiotics: If caused by a bacterial infection, intravenous antibiotics are typically used, sometimes for several weeks.
• Antifungal medication: For fungal endocarditis, antifungal medications are prescribed.
• Surgery: In severe cases, if heart valves are damaged or infected, surgery may be required to repair or replace the valve.

Myocarditis (inflammation of the heart muscle):

• Antiviral or antibiotic treatment: If caused by a viral or bacterial infection, appropriate medications are used.
• Anti-inflammatory medications: Drugs like corticosteroids may be used to reduce inflammation, especially if an autoimmune disease is involved.
• Heart medications: To manage symptoms such as heart failure or arrhythmias, doctors may prescribe beta-blockers, ACE inhibitors, or diuretics.
• Rest: Avoiding strenuous activities allows the heart to heal and reduces the risk of complications.
• Immunosuppressive therapy: In some autoimmune cases, medications to suppress the immune system may be necessary.

Pericarditis (inflammation of the heart’s outer lining):

• Anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are commonly used to reduce inflammation and relieve pain.
• Colchicine: This medication may be prescribed to reduce symptoms and prevent recurrences.
• Corticosteroids: For more severe cases or when other treatments are ineffective, corticosteroids may be used.
• Antibiotics: If pericarditis is caused by a bacterial infection, antibiotics are prescribed.
• Pericardiocentesis: In severe cases where fluid builds up around the heart (pericardial effusion), doctors may need to drain the excess fluid using a procedure called pericardiocentesis.
• Surgery: Rarely, surgery (pericardiectomy) may be needed to remove part of the pericardium if it becomes thickened and restricts the heart’s function (constrictive pericarditis).

General Management for All Types of Carditis:

• Treat underlying conditions: Managing any infections, autoimmune diseases, or other contributing factors is crucial.
• Hospitalization: Severe cases may require monitoring in a hospital setting, especially if heart failure, arrhythmias, or other complications occur.

Early diagnosis and treatment are key to preventing complications, such as heart failure or damage to heart structures. Regular follow-ups with a healthcare provider are essential.