In addition to the relatively common heart diseases described above, a wide variety of other diseases can also affect the heart. These include tumors, heart damage from other diseases such as syphilis and tuberculosis, and inflammation of the heart muscle, pericardium, or endocardium.
Myocarditis, or inflammation of the heart muscle, was commonly caused by rheumatic fever in the past. Today, many cases are due to a viral infection or their cause cannot be identified. Sometimes myocarditis simply goes away on its own. In a minority of patients, who often suffer repeated episodes of inflammation, myocarditis leads to permanent damage of the heart muscle, reducing the heart’s ability to pump blood and making it prone to developing abnormal rhythms.
Cardiomyopathy encompasses any condition that damages and weakens the heart muscle. Scientists believe that viral infections cause many cases of cardiomyopathy. Other causes include vitamin B deficiency, rheumatic fever, underactivity of the thyroid gland, and a genetic disease called hemochromatosis in which iron builds up in the heart muscle cells. Some types of cardiomyopathy can be controlled with medication, but others lead to progressive weakening of the heart muscle and sometimes result in heart failure.
In pericarditis, the most common disorder of the pericardium, the saclike membrane around the heart becomes inflamed. Pericarditis is most commonly caused by a viral infection, but may also be due to arthritis or an autoimmune disease such as systemic lupus erythematosus. It may be a complication of late-stage kidney disease, lung cancer, or lymphoma; it may be a side effect of radiation therapy or certain drugs. Pericarditis sometimes goes away without treatment, but it is often treated with anti-inflammatory drugs. It usually causes no permanent damage to the heart. If too much fluid builds up around the heart during an attack of pericarditis, the fluid may need to be drained with a long needle or in a surgical procedure. Patients who suffer repeated episodes of pericarditis may have the pericardium surgically removed.
Endocarditis is an infection of the inner lining of the heart, but damage from such an infection usually affects only the heart valves. Endocarditis often develops when bacteria from elsewhere in the body enter the bloodstream, settle on the flaps of one of the heart valves, and begin to grow there. The infection can be treated with antibiotics, but if untreated, endocarditis is often fatal. People with congenital heart defects, valve damage due to rheumatic fever, or other valve problems are at greatest risk for developing endocarditis. They often take antibiotics as a preventive measure before undergoing dental surgery or certain other types of surgery that can allow bacteria into the bloodstream. Intravenous drug users who share needles are another population at risk for endocarditis. People who use unclean needles, which allow bacteria into the bloodstream, frequently develop valve damage.