Autoimmune heart disease

Cause

These conditions most often arise in children following a streptococcal sore throat, similar to post-streptococcal glomerulonephritis. Antibodies against the bacteria cross-react with heart antigens, causing inflammation.

Pericarditis inflames the pericardium, potentially leading to pericardial effusion, cardiac tamponade, or later constriction. Myocarditis inflames the heart muscle, reducing function and possibly causing fatal pancarditis. Endocarditis affects the inner lining and valves, causing prolapse, adhesion, or stenosis.

Diagnosis

Echocardiography detects pericardial effusion, valve abnormalities, or reduced function. ECG identifies arrhythmias or conduction issues. Blood tests show elevated inflammatory markers and anti-streptolysin O titers in rheumatic disease.

Cardiac MRI assesses myocardial inflammation or fibrosis. Cardiac biopsy and the Jones criteria (based on major and minor criteria with evidence of prior streptococcal infection) are also used. Imaging may reveal focal fibrosis, wall motion changes, oedema, or larger left ventricle dimensions.

Did You Know?

• Autoantibodies or auto-toxic T-lymphocytes mediate tissue destruction, aided by neutrophils, complement, tumor necrosis factor alpha, and interleukin-6.
• Persistent inflammation can lead to fibrosis, scarring, and loss of normal cardiac architecture.
• Colchicine can help prevent recurrences in pericarditis.