Because the symptoms of heart inflammation vary depending on which type it is and from one person to the next, it is sometimes hard to diagnose endocarditis, pericarditis, or myocarditis. Your doctor may do a physical exam and order tests.
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 any other risk factors for heart inflammation, including exposure to certain medicines or toxins or a travel history that may be significant?
They may also do one or more of the following steps:
- Check your legs for swelling, a sign of heart failure.
- Check your skin for any changes, as may be seen in cases of endocarditis
- Check your temperature to determine if you have a fever
- Feel your stomach, particularly for a spleen that is larger than normal, or to determine if you have abdominal pain, which may occur with endocarditis
- Listen to your heart for a new murmur that may be heard with endocarditis, a pericardial rub that may be heard with pericarditis, or an abnormal heart rhythm
- Listen to your lungs
Imaging tests and procedures
Your doctor may need to do images tests or procedures to look at your heart.
Heart imaging tests take pictures of your heart or its arteries or blood vessels to help your doctor see whether there are any problems.
Endomyocardial biopsy (EMB) tests very small pieces of the heart to look for myocarditis.
Heart valve tissue testing identifies tiny germs or microbes from the heart valve or other growths found there that may be causing your endocarditis.
Pericardiocentesis removes excess fluid in the pericardium, called pericardial effusion. Your doctor will insert a needle or tube, called a catheter, into the chest wall to remove this excess fluid.
Your doctor 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 and treat the exact bacterium, virus, or fungus that is causing the infection in 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 are useful to show injury to the heart muscle.
However, they also increase with heart attack or heart failure and do not necessarily mean you have myocarditis. They are often normal in cases of subacute or chronic myocarditis.
C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) may indicate inflammation in the body if higher than normal.
Complete blood count 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 attack your own heart muscle.
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