Continuing Professional Development: Considering infections of the heart

After completing this module the paramedic will be able to:

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Infections of the heart can result in significant harm and includes cardiac tamponade, congestive heart failure, emboli, dilated cardiomyopathy (DCM) and death (McDonald, 2009; Blauwet and Cooper, 2010; Curry, 2014). These infections can be broken down into three main areas that correspond with the layers of the heart: endocarditis (endocardium), myocarditis (myocardium) and pericarditis (pericardium). Out of the three, the most common is pericarditis, which accounts for 5% of all chest pains that are presented to emergency departments (Curry, 2014). Forms of pericarditis are included in the differential diagnosis algorithm for chest pain that is documented by Naumov (2009). It is also included by Snyder et al (2012) as one of the causes of non-acute coronary syndrome (non-ACS). These indicate its prevalence enough to be considered as a relatively common cause of chest pain. Although reported cases of myocarditis are not as high as pericarditis, it is a disease that can cause life-threatening complications. It is mostly notable in the paediatric patient, where it accounts for 12% of sudden cardiac death among adolescents and young adults (Levine et al, 2010). Endocarditis has a high mortality rate for those who contract it (Weymann et al, 2014). In the general population, the incidence of endocarditis is low (1.7–6.2 cases per 100 000 patients). This rises significantly in intravenous drug users (IVDU) to 2–5% and is responsible for 5–10% of deaths in this patient group (Weymann et al, 2014).