What are the Symptoms of Viral Endocarditis?

Understanding the Key Symptoms of Viral Endocarditis

Viral endocarditis is a rare inflammation of the inner lining of the heart chambers and valves, caused by a viral infection. While often associated with bacterial infections, viruses can also cause endocarditis, particularly in certain scenarios.

Additionally, individuals may experience flu-like symptoms like chills, night sweats, and muscle aches. Some patients may also notice swelling in their feet, legs, or abdomen, as well as shortness of breath or chest pain when breathing.

Keep reading to understand everything about viral endocarditis.

Understanding Viral Endocarditis

Viral endocarditis is inflammation of the endocardial tissue resulting from viral infiltration. From limited case reports, a known cause of viral endocarditis is an enterovirus, specifically coxsackie B2. The illness is usually underestimated in everyday practice since it happens infrequently and is hard to diagnose.

In contrast to bacterial endocarditis, it does not necessarily happen with classic symptoms; therefore, the diagnosis is more difficult to establish. Even though occasional human infection occurs, studies with animals like mice have shown the pathogenicity of the viral pathogen in developing inflammation of the endocardium.

What are the Causes of Viral Endocarditis?

Viral myocarditis has been caused by various viruses, including adenoviruses and enteroviruses such as coxsackieviruses. While uncommon in humans, viral endocarditis is more apparent in animal models.

In a 1966 laboratory study, mice were inoculated with coxsackie virus-containing culture fluid. Valvular endocarditis was observed in 55% of infected mice, and mural endocarditis in 50% of infected mice. The Coxsackie virus was isolated from the affected heart valves and endocardial tissue, with viral antigens detected through immunofluorescence.

These comparable animal studies suggest that viruses may play a causal role in endocardial damage, which is typically associated with bacterial and fungal infections.

What are the Symptoms of Viral Endocarditis?

Patients may present with respiratory distress, ventricular dysfunction, dehiscence of prosthetic patches, or even signs of heart failure and pulmonary hypertension. However, little is known about the symptoms of viral endocarditis.

Viral endocarditis often overlaps with myocarditis, presenting non-specific signs such as chest pain, elevated cardiac enzymes, and ECG abnormalities. In some cases, patients remain asymptomatic until severe complications arise.

What is the Potential Treatment for Viral Endocarditis?

Acute viral myocarditis has been considered one of the most difficult to treat in cardiology and, therefore, warrants careful investigation before initiating effective treatment. Available treatments can be categorized into 2 broad groups depending on presenting symptoms:

• Definitive treatment
• Supportive treatment

Supportive therapy is administered to patients who present with myocarditis, heart failure, and acute coronary syndrome-like symptoms.

Nonsteroidal anti-inflammatory drugs and colchicine alleviate pericarditis symptoms such as chest pain. β-blockers, diuretics, and angiotensin-converting enzyme inhibitors may be administered to patients with heart failure manifestations due to viral myocarditis.

Circulatory assistance in the form of intra-aortic balloon pumps and extracorporeal membrane oxygenation may also be added based on the disease course and severity of hemodynamic impairment. In severe viral myocarditis, cardiogenic shock may occur and can be fatal without prompt treatment.

Viral endocarditis remains a rare and underdiagnosed condition due to its nonspecific symptoms and limited clinical awareness. Its diagnosis is challenging, and treatment is mostly supportive, guided by symptom severity.

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