Back To CoursePathophysiology Textbook
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Ever have heartburn? The heart doesn't really burn during heartburn, but it sure feels like it. The burn that you feel is due to inflammation occurring within your esophagus, the tube that connects your mouth to your stomach.
But inflammation can occur anywhere in your body so long as something triggers it there. Sometimes it occurs inside and right outside your heart, resulting in actual heartburn, if you will. This is what we'll focus on in this lesson, when inflammation affects your heart.
The inner layer of the heart that lines the chambers of the heart is known as the endocardium. Inflammation of the endocardium is termed, appropriately, endocarditis, where the suffix '-itis' refers to the inflammation of something.
One major cause of endocarditis is by way of entry of germs (such as Staphylococcus aureus) into the bloodstream. When this occurs, we term it infective endocarditis for obvious reasons. These germs can enter your blood through your mouth (especially in cases of gingival disease), or via a catheter placed in your veins, or some other way. Once in the body, they then travel to the heart via the bloodstream.
The majority of people who develop infective endocarditis already have some kind of predisposing problem with the heart, especially damage to the heart valves as a result of something like rheumatic heart disease. This is an inflammatory condition of the heart that occurs as a result of an autoimmune reaction to infection by streptococcal bacteria.
Damaged heart valves (many times the mitral valve) or other predisposing congenital heart defects do not allow blood to flow properly through the heart.
The valves of your heart work just like valves do in plumbing systems. They are located between chambers of your heart, the atria and ventricles, and allow blood to flow through only at certain times. Otherwise, when they are closed, blood does not flow from one chamber to another.
As a result of valve damage, improper blood flow predisposes not only to further damage to the endocardium and valves but also to clot formation within the heart. After the heart is already damaged and bacteria enter the bloodstream, the bacteria and blood clot components come together and form what's known as vegetative lesions or vegetations, usually on the edge of the heart valve itself. The bacteria hide in these vegetative lesions very well, making it very difficult for your immune system to kill the bacteria. All of this damage can lead to valvular prolapse, regurgitation, and congestive heart failure.
Valvular prolapse refers to the fact that the heart valves, the guys that separate blood between heart chambers, are unable to close properly. This inability to close properly leads to regurgitation, which is when blood flows back in the opposite direction of normal blood flow because the valves don't close properly.
Just like a person regurgitating implies food comes out of the mouth (the wrong way), so too does regurgitation in the heart imply that blood is flowing in the wrong direction.
To diagnose this problem, an echocardiogram can help a doctor visualize vegetative lesions as well as valvular prolapse, and a blood culture test can help identify any bacteria in the bloodstream. A lot of antibiotics to treat the infection as well as surgery to correct any heart defects will be important in many cases of infective endocarditis.
On the complete opposite side of the heart is the pericardium, the tough and protective membranous sac that surrounds the heart. Inflammation of the pericardium is termed pericarditis. When it is sudden and severe, it is termed acute pericarditis, and over a long period of time, it is called chronic pericarditis.
Pericarditis can occur as a result of infection, autoimmune disease such as lupus, and many other things.
A common symptom of pericarditis is chest pain in the left side of the chest and behind the breastbone. This pain is especially worse during inspiration, which means 'breathing in.'
An important sign of pericarditis audible upon auscultation of a patient is a pericardial friction rub. Upon auscultation (listening to the heart by way of a stethoscope), it will sound as if leather is rubbing up against leather. This is indicative of the two layers of the pericardium rubbing against one another during pericarditis.
Another important diagnostic clue of pericarditis can be gleaned from an electrocardiogram. This test measures the electrical activity of the heart. During pericarditis, the EKG will show abnormal waveforms, such as depression of the PR segment.
Treatment for pericarditis involves anti-inflammatory medications as well as pain-relieving drugs. This is in addition to any antibiotics that may be necessary if an infective cause is suspected.
This lesson discussed two important causes of inflammatory heart disease. They were pericarditis and endocarditis.
The inner layer of the heart that lines the chambers of the heart is known as the endocardium, and its inflammation, the inflammation of the endocardium, is termed endocarditis.
People who develop infective endocarditis may already have had or have a problem such as rheumatic heart disease. This is an inflammatory condition of the heart that occurs as a result of an autoimmune reaction to infection by streptococcal bacteria.
The other inflammatory condition we discussed is associated with the pericardium, the tough and protective membranous sac that surrounds the heart. The inflammation of the pericardium is termed pericarditis.
A common symptom of pericarditis is chest pain in the left side of the chest and behind the breastbone. Further still, an important sign of pericarditis audible upon auscultation of a patient is a pericardial friction rub. Upon auscultation (listening to the heart by way of a stethoscope), it will sound as if leather is rubbing up against leather. Abnormalities on an electrocardiogram during pericarditis are not uncommon either.
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Back To CoursePathophysiology Textbook
20 chapters | 274 lessons