Carditis

Are you suffering from acute chest pain and prominent fever with chills? It is quite likely that you are having a medical condition called Carditis. Read on to know more about the causes, symptoms, diagnosis and treatment of this disease.

Carditis Definition

Carditis refers to a sudden swelling and redness of the heart muscles and its surrounding areas.

Carditis ICD 9 Code

The ICD 9 code for Acute Pericardiatis is 420.90.

Carditis Types

Depending on the symptoms, the condition is broadly classified into three categories:

• Pericarditis – It is marked by redness of the pouch shaped casing around the heart, commonly known as Pericardium.
• Endocarditis – It is characterized by the inflammation of the endocardium, the inner linings of heart valves and heart chambers.
• Myocarditis – It is identified by the redness of the cardiac muscles.

Picture 1 – Myocarditis

Carditis Causes

The causes of Carditis depend on the type of the disorder that the patient is suffering from.

Pericarditis Causes

It can be caused due to:

• Heart attacks
• Use of Radiation therapy on chest
• Any kind of trauma (injury) to the heart
• Certain medicines that repress the immune system

Endocarditis Causes

One of the primary causes of Endocarditis is severe bacterial infection. However, fungi also serve as one of the major causes of this condition.

Myocarditis Causes

This unusual disorder is caused mainly by fungal, bacterial or viral infections that reach the human heart via various modes.

Fungal Infections

• Candida
• Aspergillus
• Cryptococcus
• Histoplasma
• Coccidioides

Bacterial Infections

• Treponema
• Mycoplasma
• Chlamydia
• Streptococcus

Viral Infections

• Cytomegalovirus
• Herpes
• Coxsackie
• Hepatitis C
• Parvovirus
• HIV

Other secondary causes of Myocarditis include:

• Being in contact with chemical compounds.
• Certain diseases, such as Rheumatoid Arthritis and Sarcoidosis, which cause swelling of the body. This leads to Myocarditis.
• Atypical effect of certain toxins namely cocaine, alcohol, heavy metals etc.

Carditis Symptoms

This disease encompasses a number of symptoms which indicate to sufferers that they should take preliminary precaution to evade it.

Pericarditis Symptoms

• Anxiety
• Chest Pain may spread out to shoulder, neck and back.
• Fatigue.
• Swelling of feet, ankle and legs.
• Breathing problems when lying down.
• Fever.
• Dry Cough.

Endocarditis Symptoms

• Frequent Chills
• Joint pain
• Irregularity of the heart valve
• Weakness
• Breath shortness during activity
• Red skin spots on the soles and palms
• Abnormal urine color
• Fatigue.
• Night sweats
• Excessive sweating
• Feet, legs and abdomen swelling
• Paleness
• Muscle aches and pains
• Abnormal nails
• Weight loss
• Painful nodes in the pads of the toes and fingers.

Myocarditis Symptoms

• Chest pain, similar to heart attack
• Leg swelling or joint pain.
• Abnormal heartbeat
• Breath Shortness
• Irregular heart rhythms that causes one to faint
• Fever
• Headache, sore throat, diarrhea, muscle aches or rashes
• Low urine output.
• Fatigue

Carditis Diagnosis

The diagnosis of this particular disease requires certain clinical procedures and techniques depending on the category of the disorder.

Pericarditis Diagnosis

Diagnosis of Pericarditis requires a number of medical procedures like:

• Chest X-ray- It helps doctors analyze the shape of the heart and locate any kind of enlargement due to accumulation of excess fluid in the pericardium.
• Computerized tomography- Also known as CT scanning, this technique gives detailed information about the pericardium inside the body and eliminates blood clot in the lungs or any aortic dissection.
• Magnetic resonance imaging- Popularly known as MRI, this medical technique uses radio waves along with a magnetic field to create an image of the heart which displays even the minute changes in the pericardium.
• Electrocardiogram- Also termed as ECG, this technique uses certain patched wires and attaches them to the skin to determine the electrical impulses emitted by the heart.

Endocarditis Diagnosis

Proper physical examination and evaluation of the symptoms is required to diagnose this particular disease in the right manner. In many cases, patients suffering from this ailment suffer from frequent fever. Echocardiogram (cardiac echo) is the apt medical procedure to diagnose this medical condition and helps the patient to identify with the intensity of the disease.

Myocarditis Diagnosis

It can be determined with the aid of ECG-electrocardiographic, CRP-C reactive protein and ESR-Erythrocyte sedimentation rate. Such medical procedures help diagnose the disease at an early stage and cure patients easily.

Carditis Treatment

It is compulsory to treat different categories of Carditis individually for better results.

Pericarditis Treatment

Doctors and physicians initially attempt to find out the real cause of this medical disorder. In order to cure this disease, doctors provide medications that include:

• Antibiotics for healing Bacterial Pericarditis
• Colchicine
• Antifungal medications (for  curing Fungal Pericarditis)
• Corticosteroids
• Analgesics (for intense pain)
• Ibuprofen (a non-steroidal anti-inflammatory drug), to suppress the inflammation of the pericardium

In case of chronic pericarditis, removal of the pericardium is strictly suggested.

Endocarditis Treatment

People suffering from this kind of disease should be hospitalized for regular antibiotics therapy, which helps flush out the bacteria from the cardiac chambers. With the help of blood culture and sensitivity of the tests, patients undergo an antibiotic therapy of 4 -6 weeks of duration. Antibiotics are injected for destroying the particular type of organism causing this medical condition. Medical surgery to alter the heart valve is only required when the infection is causing a chain of strokes or damaging any heart valve (resulting in heart failure).

Myocarditis Treatment

Treatment of this kind of disorder includes prescription medicines to cure any kind of heart failure. Pacemakers, cardioverter-defibrillator and essential medicines are required to treat unusual heart rhythms. Treatment of this particular disease also includes:

• Anti-inflammatory medicines to reduce inflammation
• Antibiotics
• Reduced activity
• Diuretics to eradicate excess water from the body
• Diet with low salt content

Carditis Incidence

The frequency of this disease among the patients is determined by its category. Pericarditis is very rare among patients and impacts men aged between 20 and 50 years. While Endocarditis is quite common, Myocarditis is a rare medical condition that is usually caused by different types of infections spreading to the heart.

Carditis Risk factors

The type of associated risks tends to vary depending on the form of the disease.

Pericarditis Risk Factors

This type of medical condition can give rise to various diseases that may cause:

• Leukemia
• Kidney failure
• Tuberculosis
• Autoimmune disorders

• Rheumatic fever
• AIDS and HIV infection
• Hypothyroidism

Endocarditis Risk Factors

The risk factors for this type include:

• Enduring central venous access lines
• Recent dental surgery
• Injection drug use
• Prior valve surgery
• Weakened valves

Mayocarditis Risk Factors

This form of the disease does not involve any risk factors.

Rheumatic Carditis

Picture 2 – Acute Rheumatic Carditis

Swelling of the heart caused by rheumatic fever is termed as Rheumatic Carditis. Rheumatic fever is considered to be a sure cause for this type of ailment. This condition severely affects the myocardium, endocardium and pericardium. The symptoms of this medical problem include

• Cardiac pain
• Palpitations in the heart
• Arrhythmia
• Debility
• Dyspnea, after mild physical exertion

People suffering from this condition require effective treatment to reduce swelling and adjust cardiac shortage.

Lyme Carditis

It is an inflammatory disorder caused by the bacteria Borrelia burgdorferi and is passed on to humans with the help of Deer Tick. This particular disease is common among those with no previous cardiac issues and can be cured with proper medical aid. The symptoms of this condition are quite intimidating for the sufferers and include problems like:

• Dizziness
• Breathlessness
• Palpitations
• Slowing of the heart rhythm
• Throbbing sensations in the neck

For mild cases, a four-week course of doxycycline is adequate, whereas, for severe conditions, treatment by intravenous antibiotics is highly recommended.

Carditis, irrespective of any category, can be cured completely if proper medication and treatment is given to the patient at the right time. Naturally, you should seek emergency medical attention if any of your friends or family members displays its symptoms.

References:

http://www.atsu.edu/faculty/chamberlain/Website/lectures/tritzid/carditis.htm

http://www.uptodate.com/contents/lyme-carditis

http://www.nlm.nih.gov/medlineplus/ency/article/001098.htm

http://www.ehealthnews.eu/carditis