"Support for Prevention of Heart Disease and Stroke"

Heart Disease - Diseases of the Inner and Outer Lining of the Heart

Endocarditis Is an inflammation of the endocardium. It affects primarily the valve structures and maybe infective or non-infective. Apart from Rheumatic fever, the most common non- infective is that due to Systemic Lupus Erythematosus (S.LE) is treated by treating the lupus. Infective Endocarditis

This may be acute or sub acute and due to bacteria, fungi, chlamydia and other organisms. Most common is the bacterial sub acute type. This seldom affects a previously normal heart, but tends to be imposed where there was a pre-existing defect such as an abnormal or diseased mitral or aortic valve. The source of organism in the majority of cases is the oral cavity with a history of dental infection or treatment.

The infection leads to the formation of friable vegetations on to affected valves and endocardium. Pieces of vegetation may embolise to other parts of the body such as the brain and kidneys producing appropriate symptoms such as stroke and haematuria. The other symptoms tends to be non-specific, mainly fever, anaemia and weightless specific cardiac type symptoms are rare and late and indicate catastrophic complications.

Prevention and Treatment of Diseases of the Linig of the Heart:

Prolonged antibiotic therapy is essential. When the infection is over, surgery may be necessary for the replacement of damaged valves.

All performed at risk because of pre-existing valve or other structures abnormalities of the heart should pay attention to oral hygiene and should be aware of the need to have antibiotic cover for dental procedures, genetic-urinary surgery and other procedure in which infection is likely.

Acute Pericarditis
Inflammation of the outer lining sac which envelops the heart like endocarditis be infective or non infective in organ. However, if infective the constrict organism is usually viral. The main symptom is pain.

Treatment consists of pain relief and managing the underlying condition for example lupus.

Pericardial Offusion
Here there is a collection of fluid between the heart and the pericardium. It us usually without symptoms and requires no treatment unless it is infected or causing Tamponade.

Pericardial Tamponade
Here the effusion collects rapidly, not giving the percardium time to stretch to accommodate it. It can collect therefore only by compressing the underlying heart muscle, the ventricles in turn are unable to fill properly and the heart rapidly fails as a pump. If sever acute circulatory failure rapidly develops. This will be rapidly fatal and relief by paracentesis or surgery is urgent.

Constrictive Pericarditis
In this rare condition, a thickened fibrosed and often-calcified pericardium constricts the heart. It is a late complication of certain pericardial infections, malignant incision and haemorrhage into the pericardium. The symptoms are of cardiac failure with abdominal swelling and ascitis dominating over limb oedema and dyspnoea.  The treatment is surgical stripping of the pericardium.

Malignancies Involving the Heart
These will be addressed here as they fall more within the realm of oncology than cardiology, but the initial symptoms may be any of those mentioned in the other condition of the heart.