When an infection invades the heart

Compared with other heart problems, heart infections are uncommon. But sometimes they trigger inflammation that can damage the heart, which is why you should be aware of the risks and symptoms.

“Infections can start in various places in the body — the mouth, the lungs, or the gastrointestinal tract. But they can spread to the heart through the bloodstream,” explains Dr. Dale Adler, a cardiologist at Harvard-affiliated Brigham and Women’s Hospital. Certain viruses — including SARS-CoV-2, which causes COVID-19 — can directly infect cells in the muscle and blood vessels of the heart, hijacking the cells’ basic machinery and causing destructive inflammation, he adds.

In addition to infections, other illnesses or medical procedures may cause inflammation in various areas of the heart. There are three main categories of heart inflammation, classified by where they occur. Following is a summary of the common causes and symptoms of each one, along with other helpful information.


Pericarditis is swelling and irritation of the protective, double-layered membrane that surrounds the heart, called the pericardium. Most often, pericarditis is triggered by a viral infection, but it can also be caused by other types of infections or illnesses, radiation therapy for cancer, or a reaction to medication. Complications from bypass surgery or a heart attack are other possible triggers.

The classic symptom is a sharp pain in the middle or left side of the chest. “The pain often gets worse if you take a deep breath or lie down, because both of those actions stretch the pericardium,” says Dr. Adler. Other possible symptoms include fever, weakness, muscle aches, and feeling tired.

Most of the time, the symptoms of pericarditis go away in a few weeks or less, with the help of anti-inflammatory medications such as ibuprofen (Advil, Motrin) and the prescription drug colchicine (Colcrys, Mitigare), a drug long used to treat gout.


Myocarditis is inflammation in the middle, muscular layer of the heart. Most cases stem from an infection, usually from a virus that causes stomach flu or the common cold. Mild -myocarditis may go unnoticed, but severe, sudden cases can cause severe heart failure and rhythm disturbances.

But this rare condition is often challenging to diagnose. “Myocarditis is known as the great mimicker, because it can cause symptoms similar to a heart attack, such as chest pain and shortness of breath,” Dr. Adler says. Knowing whether a person had the flu or another infection in recent weeks is an important clue, he adds. Common tests such as electrocardiograms cannot always distinguish myocarditis from a heart attack, but an MRI scan can reveal areas of inflammation. Treatment may include medications to improve heart pumping action or correct abnormal heart rhythms. Some people end up needing implanted devices to address these complications.


Endocarditis is an infection of the heart’s inner lining (the endocardium) or one or more of the heart’s valves. It is usually caused by bacteria that enter the bloodstream and settle on the endocardium or valves, especially diseased or damaged valves.

“Foreign material in the body, such as an artificial heart valve or pacemaker, can’t mount an immune response. So bacteria circulating through the blood will have a higher chance of proliferating on those surfaces,” Dr. Adler explains. The organism can enter the bloodstream through a break in the skin or via a mucous membrane. This can happen during certain dental, diagnostic, or surgical procedures, or with intravenous drug use.

Guidelines from the American Heart Association advise people who face a high risk of endocarditis to take antibiotics before having certain dental, surgical, or other invasive procedures. This includes people who

  • have serious valve disease
  • had surgery to repair or replace a heart valve
  • had infective endocarditis in the past
  • have certain congenital heart defects, even if the defect has been repaired.

Endocarditis symptoms include fever, chills, night sweats, and shortness of breath. Some people develop a new heart murmur or a change to an existing heart murmur. Damage to a heart valve may lead to heart rhythm problems or heart failure, and the valve may need to be surgically replaced. Endocarditis may also cause tiny clots that travel to other parts of the body, such as the brain, legs, arms, or gastrointestinal tract. Treatment usually requires high-dose intravenous antibiotics for at least four weeks and sometimes longer.

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

Ecclesiastes 11:6 Sow your seed in the morning and do not be idle in the evening, for you do not know whether morning or evening sowing will succeed, or whether both of them alike will be good.

Proverbs 16:3 Commit your works to the LORD And your plans will be established.

Esther 8:15 Then Mordecai went out from the presence of the king in royal robes of blue and white, with a large crown of gold and a garment of fine linen and purple; and the city of Susa shouted and rejoiced.

Deuteronomy 29:9 “So keep the words of this covenant to do them, that you may prosper in all that you do.

Psalm 118:25 O LORD, do save, we beseech You; O LORD, we beseech You, do send prosperity!

Proverbs 15:22 Without consultation, plans are frustrated, But with many counselors they succeed.

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