Cardiac inflammation is a new potential symptom of coronavirus for children according to a recent NHS alert. At least 12 children in the UK have needed intensive care due to the new type of toxic shock syndrome which causes pain and inflammation. But what exactly is cardiac inflammation?
More than a dozen children have fallen ill with new symptoms linked with COVID-19, including a sore throat and heart problems.
Of the dozen or more children admitted to intensive care, many needed treatment for heart inflammation.
The blood samples are consistent with children suffering from severe COVID-19 infections and look similar to patients with toxic shock syndrome or “atypical Kawasaki disease”.
Kawasaki disease mainly affects children under five and can cause the blood vessels to become inflamed and swollen, leading to complications in the vessels that supply blood to the heart.
There are different types of cardiac inflammation: myocarditis, pericarditis and endocarditis.
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What is myocarditis?
Myocarditis is the inflammation of the heart muscle, known as the myocardium.
It is usually caused by a viral, bacterial or fungal infection and usually causes pain or tightness in your chest which can spread to other parts of your body.
Symptoms of myocarditis include:
- Shortness of breath
- Flu-like symptoms, such as high temperature, feeling tired, headaches and aching muscles and joints.
- Stabbing pain and/or tightness in the chest which may spread across the body
- Palpitations or abnormal heart rhythm.
What is pericarditis?
Pericarditis is inflammation of the protective sac that surrounds your heart, known as the pericardium.
The pericardium has an inner and outer layer and can become inflamed if blood and fluid leak between the two layers or the sac itself becomes damaged.
Pericarditis can occur if:
- You have recently had a heart attack or heart surgery
- You have a virus or bacterial infection, such as the flu
- You have another inflammatory condition, such as rheumatoid arthritis
- You have kidney failure or in rare cases some forms of cancer
- Symptoms of pericarditis are very similar to those of angina and typically feel like having a heart attack, such as a sharp and stabbing pain in the chest.
- It can also feel tight and crashing and spread to your arms, jaw, back or stomach.
- The chest pain may worsen as you breathe deeply and you may also experience shortness of breath, feeling sick, sweaty and lightheaded.
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What is endocarditis?
Endocarditis is a rare condition which occurs when the inner lining of the heart, most commonly one of the heart valves becomes infected.
Endocarditis is caused by a certain type of bacteria or another type of infective organism, which enters into your bloodstream and travels to your heart.
This rare condition can be life-threatening if not treated quickly but symptoms can be very subtle and non-specific, developing slowly over a few weeks or sometimes months, or perhaps very quickly.
The most common symptoms include:
- Flu symptoms including a fever, tiredness, headaches, aching muscles and joints, cough and sore throat.
- Weight loss
- A heart murmur.
How is cardiac inflammation diagnosed?
Sometimes symptoms of heart inflammation will disappear on their own, but most likely you will need to have an electrocardiogram (ECG), echocardiogram and various blood tests to diagnosis cardiac inflammation.
An echocardiogram is a scan of your heart which is similar to an ultrasound.
You may also be required to get a chest X-ray and an MRI or CT scan on your chest to diagnose pericarditis.
What is the treatment for cardiac inflammation?
The different types of cardiac inflammation are treated differently.
Myocarditis is often mild and goes unnoticed, but you may need to take medicines to relieve your symptoms such as non-steroidal anti-inflammatories.
If one’s myocarditis causes significant problems with how well your heart pumps, you may develop heart failure which in severe cases may mean you will be considered for a heart transplant.
With pericarditis, you may receive medicines to relieve your symptoms and reduce the pain and inflammation.
You may also need to take other painkillers, aspirin and corticosteroids.
If you have a large amount of fluid in your pericardial sac, you may need pericardiocentesis which involves inserting a thin tube through the chest wall to drain the fluid.
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