🫀 Endocarditis vs. Pericarditis: What’s the Difference?

At *Global Health, we often encounter questions about the differences between **endocarditis* and *pericarditis*—two conditions that affect the heart, but in very distinct ways. Understanding their pathophysiology, symptoms, causes, and treatment options is key to timely diagnosis and effective management.

Below is a concise comparison to help clarify the two:

---

### ✅ *Endocarditis: Infection Inside the Heart*

*🔬 Pathophysiology*

Endocarditis is an *inflammation of the endocardium, the inner lining of the heart, often involving the **heart valves*. It can be:

* *Infective*: usually bacterial (think of it as “mold” forming on heart valves)

* *Non-infective*: inflammation without actual infection

Damaged valves may not close fully, leading to poor cardiac output and reduced oxygen delivery.

*🔍 Common Causes*

* Use of *dirty needles* (e.g., IV drug use)

* *Dental procedures* (especially without prior antibiotics in at-risk patients)

* *Valve replacements* or prior *heart surgeries*

* *Untreated strep throat*

*🩺 Key Signs & Symptoms (C.L.O.T.)*

* *C: Clots (risk of **stroke, **splinter hemorrhages*)

* *L*: Lung crackles (sign of heart failure)

* *O*: Overheated (fever), Osler’s nodes, Janeway lesions

* *T*: Too little oxygen (low output), clubbing fingers

*💊 Treatment*

* *Intravenous antibiotics*

* *Valve repair or replacement surgery* if necessary

*🧠 Patient Education (M.O.L.D.)*

* *M*: Monitor for infection

* *O: Oral hygiene—brush 2x/day, no flossing*

* *L*: Let all providers know about history of endocarditis

* *D: Dental visits or surgery—stress the importance of **antibiotic adherence*

---

### ✅ *Pericarditis: Inflammation Outside the Heart*

*🔬 Pathophysiology*

Pericarditis is an *inflammation of the pericardium, the sac surrounding the heart. The inflammation or fluid buildup can **compress the heart*, restricting its ability to pump effectively.

*🔍 Common Causes (H.A.I.R.)*

* *H*: Heart Attack (especially post-MI inflammation)

* *A*: Autoimmune diseases (e.g., lupus, RA, scleroderma)

* *I*: Infections (viral, bacterial, HIV, herpes)

* *R*: Renal failure (high urea levels)

*🩺 Signs & Symptoms*

* *Precordial chest pain* (often sharp and worse when lying down)

* *Elevated WBCs and CRP*

* *Cardiac tamponade*:

1. *JVD (jugular venous distension)*

2. *Muffled heart sounds*

3. *Pulsus paradoxus* (drop in systolic BP by >10 mmHg during inspiration)

*💊 Treatment*

* *NSAIDs* (e.g., indomethacin)

* *Steroids* (e.g., prednisone) in resistant or autoimmune cases

* *Pericardiocentesis*: in severe cases, fluid may need to be drained directly from the pericardial sac

---

🧾 Key Takeaways

| Feature | Endocarditis | Pericarditis |

| ------------ | ------------------------------ | -------------------------------------- |

| Location | Inner lining/heart valves | Outer sac of the heart |

| Cause | Mostly bacterial (infective) | Post-MI, autoimmune, infection, uremia |

| Symptoms | Fever, murmurs, emboli signs | Chest pain, muffled sounds, tamponade |

| Treatment | Antibiotics, surgery if needed | NSAIDs, steroids, possible drainage |

| Risk factors | IV drug use, dental work | Lupus, RA, MI, renal failure |

---

### 🩺 Final Note from Global Health

Both *endocarditis* and *pericarditis* can become life-threatening if untreated. Early recognition, proper investigation (e.g., echocardiogram, labs), and targeted treatment are essential.

If you or someone you know is experiencing chest discomfort, fatigue, fever, or unexplained neurological symptoms, seek medical attention promptly.