Reviewed By: Pramod Kerkar, MD, FFARCSI

Is a Heart Infection Serious?

Infection increases the risk of cardiovascular disease, mainly because it has been related to the arteriosclerotic process of blood vessels (it is a vascular alteration characterized by hardening, increased thickness and loss of elasticity of the arterial walls) affecting coronary arteries producing acute heart infarction, and by triggering alterations in the conduction of nerve impulses in the heart, which cause arrhythmias such as atrial and ventricular fibrillation. But also, the infection of the tissues of the heart may involve the cardiac muscle (myocarditis), of the valves (endocarditis), and of the covering that covers the heart (pericarditis).

Nowadays, cardiovascular disease continues to be one of the main causes of mortality in developed countries. Arteriosclerosis is an inflammatory disease whose genesis involves many factors, many of which are well known, such as high cholesterol levels, smoking, hypertension, or diabetes. Among the lesser known, however, is the infection.

Production of Atherogenesis by Microorganisms

It is well known by the scientific community that in the process of formation of arteriosclerotic plaque interfere immune phenomena dependent on both defensive cells and antibodies, and it is thought that some of these cells (lymphocytes) are activated by responding to a wide variety of antigens. These can be antigens of our own organism (autoantigens), but they can also be exogenous antigens such as bacteria and viruses. Although the exact mechanism is still unknown, it is thought that certain microorganisms show a specific tropism by the cells of the walls of the blood vessels (endothelial cells), which contributes to vascular damage by destroying the cells (direct cytopathic effect), the inhibition of normal programmed cell death (apoptosis) of endothelial cells or the induction of focal autoimmune responses.

It has been found that some viruses can induce the accumulation of cholesterol crystals, or other forms of it, in the muscle cells of the vessels, as well as favoring coagulation phenomena in the cells of the vessel wall.

Indirectly, during an infection, different immunopathological processes (those acting in order to determine the causes of diseases) can occur that can contribute to the chronic inflammatory process in the cell wall that triggers the arteriosclerosis. These phenomena can occur, even at a systemic level, far from where the injury will eventually occur.

Production of Arrhythmias by Microorganisms

Cardiac arrhythmias are an important cause of mortality and morbidity; they can contribute to the worsening of other heart diseases (such as heart failure), cause them on their own (such as acute myocardial infarction), or generate lesions in other organs (such as those derived from embolisms). Many factors are known that favor them, such as diabetes, valvular disease or hypertension, among others. Similar to what happened with atherogenesis, the appearance of biomarkers of inflammation in patients with cardiac arrhythmias has recently revealed the possible implication, also, of infection as a trigger mechanism. The main studies have been carried out on atrial fibrillation, which is the most frequent arrhythmia; also, evidence has been provided in ventricular fibrillation, one of the main causes of sudden death.

Unlike what happens in arteriosclerosis, in this case at the moment it has only been able to show the role of a pair of bacteria that produce chronic infections and that are also involved in atherogenesis. These infections would act as initiators of the inflammatory process and would also contribute to its maintenance. Among the available studies are the findings of histological study of tissues, where signs of inflammation are appreciated.

Despite all this, the association seems less clear than in the case of arteriosclerosis and more studies are still needed to clarify whether they play a direct role or constitute an intermediate factor.

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: May 17, 2018

This article does not provide medical advice. See disclaimer

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