Heart inflammation, also called carditis, is inflammation that affects one or more parts of the heart. It may involve the heart muscle (myocarditis), the inner lining of the heart or heart valves (endocarditis) or the protective sac around the heart (pericarditis).
Symptoms can include chest pain, fatigue, fever, shortness of breath or an irregular heartbeat. Some cases are mild, but others can become serious without treatment. Knowing the warning signs and getting prompt medical care can help protect your heart.
What are the three types of heart inflammation?
The heart has several layers, and inflammation can affect different areas:
- Myocarditis: Inflammation of the heart muscle
- Endocarditis: Inflammation of the inner lining of the heart or valves
- Pericarditis: Inflammation of the sac surrounding the heart
“The main difference between the three is the layer affected. Endocarditis is inflammation of the innermost layer, myocarditis affects the middle layer, and pericarditis affects the outermost layer,” said Beeletsega Yeneneh, MD, a cardiologist with Banner – University Medicine.
Understanding the layers of the heart
Your heart has three main layers:
- Endocardium: The inner lining of the heart chambers and valves
- Myocardium: The heart muscle that pumps blood through the body
- Pericardium: A protective sac around the heart
“The pericardium is a sac that surrounds the heart, protecting it from friction and easing its function,” said Dr. Yeneneh. “It is also where nerves and blood vessels supply and support the heart.”
Symptoms of heart inflammation
Symptoms depend on which part of the heart is affected. Some people may have mild symptoms, while others become seriously ill.
Symptoms of endocarditis
Endocarditis is often linked to bacterial or fungal infections that spread through the bloodstream.
Symptoms may include:
- Fever
- Fatigue
- Joint pain
- Night sweats
- Unexplained weight loss
- Shortness of breath
- Small red spots on the skin
Symptoms of myocarditis
Myocarditis is commonly caused by viral infections, but bacteria, fungi and parasites may also play a role.
“You may be at greater risk for myocarditis if you have a weakened immune system, a recent viral illness or exposure to certain chemicals,” Dr. Yeneneh said.
Symptoms may include:
- Fatigue
- Chest pain
- Shortness of breath
- Rapid or irregular heartbeat
- Swelling in the legs, ankles or feet
In severe cases, myocarditis can lead to heart failure or sudden cardiac arrest.
Symptoms of pericarditis
Pericarditis may be caused by viral or bacterial infections, autoimmune disorders, heart attack, cancer or radiation therapy.
Symptoms may include:
- Sharp chest pain that worsens with deep breathing or lying down
- Fever
- Cough
- Fatigue
- Shortness of breath
- Heart palpitations
- Pressure in the chest
When to seek immediate medical care
Seek emergency care right away if you have:
- Chest pain
- Trouble breathing
- Fainting
- A rapid or irregular heartbeat
- Severe weakness
- Swelling with shortness of breath
These symptoms may signal a serious heart problem.
How is heart inflammation diagnosed?
Because symptoms can overlap with many other heart and lung conditions, diagnosing carditis may take several steps.
Your provider may recommend:
- Medical history and physical exam
- Blood tests for inflammation
- Blood cultures to check for infection
- Electrocardiogram (EKG)
- Echocardiogram
- Cardiac CT
- Cardiac MRI
“If there is pericarditis and fluid accumulation around the heart, a procedure called pericardiocentesis can be done to drain the fluid, and a sample can be sent for further laboratory analysis to help find out the cause of pericarditis,” Dr. Yeneneh noted.
In some cases, doctors may recommend an endomyocardial biopsy, where a small tissue sample is taken to look for myocarditis and help identify the cause.
How is heart inflammation treated?
Treatment depends on the type of inflammation, the cause and how severe it is.
“Endocarditis is usually caused by microbial infections so treatments may include anti-microbial medicines like antibiotics, antiviral or antifungal medications,” Dr. Yeneneh said. “In rare cases of endocarditis related to autoimmune diseases, you may need blood thinners and immunomodulators, medicines that change your immune system, so it works more effectively.”
Myocarditis treatment
Myocarditis may be treated with medicines that help control inflammation and support heart function.
Pericarditis treatment
“The treatment of pericarditis involves anti-inflammatory medications to help reduce inflammation and relieve pain,” Dr. Yeneneh said.
“First-line medications for pericarditis that are usually used are a combination of colchicine and aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen,” Dr. Yeneneh said. “In cases of recurrent pericarditis, steroids can be used.”
What is the outlook for heart inflammation?
Recovery depends on the type of carditis, how severe it is and how quickly treatment begins.
Many people recover fully with prompt treatment. More serious cases may lead to long-term heart problems.
“Some people may have chronic recurrent pericarditis that may lead to significant thickening and constriction of the pericardium,” Dr. Yeneneh said. “This can put a lot of strain on relaxation and filling of the heart.”
Regular follow-up is important to watch for ongoing inflammation or complications.
How can you reduce your risk of heart inflammation?
You can lower your risk by taking steps to protect your overall health:
- Exercise regularly
- Eat a balanced diet
- Get enough sleep
- Manage stress
- Avoid illicit drug use
- Practice safer sex
- Limit alcohol
- Take care of your teeth and skin
- Wash your hands often
- Stay current on vaccinations, including flu shots
- Manage chronic conditions such as diabetes or high blood pressure
- Seek care for infections that are not improving
Bottom line
Heart inflammation can affect different parts of the heart and may range from mild to serious. Recognizing symptoms early and getting medical care quickly can improve outcomes.
If you have symptoms such as chest pain, shortness of breath or an irregular heartbeat, talk with a health care provider. Banner Health heart specialists can help diagnose the cause and guide treatment.
