Heart Inflammation
Heart Inflammation

Heart Inflammation Diagnosis

Because symptoms vary by type and from one person to the next, heart inflammation may be hard to diagnose. Your healthcare provider may do a physical exam and order tests.

History and physical exam

To help diagnose heart inflammation, your healthcare provider may ask some basic questions.

  • Have you had endocarditis, myocarditis, or pericarditis in the past?
  • Have you had a recent illness or injury to the chest?
  • Have you had any symptoms such as fever, chest pain, or shortness of breath?
  • Do you have any other medical conditions or risk factors for heart inflammation, including exposure to certain medicines or toxins or a travel history that may be significant?

They may also examine you and do one or more of the following:

  • Check your legs for swelling, a sign of heart failure
  • Check your skin for any changes that endocarditis can cause
  • Check your temperature for fever
  • Check for a spleen that is larger than normal due to an infection or for abdominal pain, which can be a symptom of endocarditis
  • Listen to your heart for a new murmur that may be heard with endocarditis, a pericardial friction rub (a grating sound) that may be heard with pericarditis, or a heart rhythm that is not normal
  • Listen to your lungs
  • Perform an electrocardiogram (EKG or ECG) to measure electrical signals from your heart and your heart rhythm.

Imaging tests and other procedures

Your healthcare provider may need to do imaging tests or procedures to look at your heart.

  • Heart imaging tests take pictures of your heart, arteries or other blood vessels to help your provider see whether there are any problems.
  • A chest X-ray shows a picture of your heart, lungs, and bones.
  • An echocardiogram uses sound waves (ultrasound) to make pictures of your heart.
  • Cardiac MRI uses a magnetic resonance imaging (MRI) machine to take detailed pictures of your heart.
  • Endomyocardial Biopsies  (EMB) tests very small pieces of the heart to look for myocarditis.
  • Heart valve tissue testing finds tiny germs, microbes, or growths that may cause endocarditis.
  • Pericardiocentesis removes extra fluid in the pericardium. Your healthcare provider will insert a flexible tube called a catheter or a needle into the chest wall to remove the fluid. They will look at the fluid for bacteria, signs of cancer, or other causes of pericarditis.

Blood tests

Blood tests may help your healthcare provider find the cause of your heart inflammation.

  • Blood cultures may identify the bacterium, virus, or fungus that is causing endocarditis or pericarditis.
  • Cardiac troponins or creatine kinase-MB are blood markers that increase when there is damage to your heart. Since there are no specific blood tests for myocarditis, these markers can be a sign of injury to the heart muscle. However, they also increase with heart attack or other injury and do not necessarily mean you have myocarditis. These markers are often normal in cases of subacute or  chronic  myocarditis.
  • C-reactive protein (CRP) levels or the erythrocyte sedimentation rate (ESR) may indicate  inflammation  in the body if higher than normal.
  • A complete blood count (CBC) looks for higher levels of white blood cells, which might indicate infection.
  • Serum cardiac autoantibodies (AAbs) are substances that your body can make if you have an  autoimmune  disease. These  antibodies  can attack your heart muscle.

Your provider may also test for organisms that can cause Lyme disease, tuberculosis, HIV, or hepatitis C.

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