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The University of Chicago Medicine - Comer Children's Hospital

Pediatric Infectious Cardiology (Heart Infections)

Sometimes, a bacterial, viral or fungal infection can affect the heart. While most heart infections in children are temporary and heal on their own without treatment, it's always important to have an infection evaluated by a medical professional. Comer Children's Hospital cardiologists have expertise in diagnosing and managing a wide range of infectious heart conditions, including endocarditis, myocarditis and pericarditis.

Endocarditis

Endocarditis is an infection in the inner lining of the heart (endocardium). It occurs when bacteria from the mouth, or elsewhere in the body, enters the bloodstream and attaches to the heart. Fungal infections or certain medical conditions, such as some autoimmune inflammatory diseases, may also cause endocarditis. Children with congenital heart disease, including valve disorders, have a greater risk for developing endocarditis. This infection is not common in kids with healthy hearts.

Symptoms

Children with endocarditis often display symptoms related to the underlying cause of the infection, such as fever, persistent cough, achy joints and/or fatigue. Other signs may include:

  • Difficulty breathing
  • Cyanosis (bluish appearance of the skin, lips and/or fingernails) or paleness
  • Development of a heart murmur
  • Fluid retention or swelling
Diagnosis

To confirm or rule out the presence of endocarditis, a cardiologist may use one or several of the following diagnostic tools:

  • Blood tests
  • Electrocardiogram (EKG), which uses electrodes to measure the electrical activity of the heart
  • Transesophageal echocardiogram (TEE), an echocardiogram performed using a scope to provide a clearer, more precise image of the heart
  • Cardiac computed tomography (CT) scan, which takes pictures of the heart using X-ray waves
  • Magnetic resonance imaging (MRI), which takes pictures of the heart using a machine with a large magnet
Treatment

If a bacterial infection is the underlying cause, the endocarditis will likely go away with antibiotic treatment. In severe cases, where endocarditis has caused heart damage, valve repair or replacement may be necessary.

Myocarditis

Myocarditis is inflammation of the middle layer of the heart wall (myocardium) that may be caused by viral infection or, less likely, bacterial or fungal infection. Allergic reaction to medication is another possible cause of myocarditis.

Symptoms

Myocarditis is very rare in young children. Older children and teenagers with myocarditis often display symptoms related to the underlying cause of the infection, such as fever, achy joints and/or fatigue. Other signs may include:

  • Difficulty breathing
  • Cyanosis (bluish appearance of the skin, lips and/or fingernails) or paleness
  • Chest pain
  • Fluid retention or swelling
Diagnosis

To confirm or rule out the presence of endocarditis, a cardiologist may use one or several of the following diagnostic tools:

  • Blood tests
  • Electrocardiogram (EKG), which uses electrodes to measure the electrical activity of the heart
  • Cardiac catheterization, which is a minimally invasive procedure that uses a small, flexible tube to examine the heart
  • Cardiac computed tomography (CT) scan, which takes pictures of the heart using X-ray waves
  • Magnetic resonance imaging (MRI), which takes pictures of the heart using a machine with a large magnet
Treatment

Myocarditis often improves without treatment. In some cases, it may be necessary to treat the underlying infection. For example, in cases where myocarditis is caused by bacteria, a cardiologist may recommend antibiotics.

Pericarditis

Pericarditis occurs when the thin, sac-like membrane around the heart (pericardium) becomes inflamed, causing a build up of fluid between its inner and outer layers. Most cases of pericarditis in children result from a viral infection. Cardiac surgery, trauma and some autoimmune inflammatory diseases may also cause irritation in the pericardium.

Symptoms

Children with pericarditis usually experience chest pain. They may also display symptoms related to the underlying cause of the infection, such as fever and/or fatigue.

Diagnosis
  • Echocardiogram, which uses sound waves to create a picture of the heart
  • Electrocardiogram (EKG), which uses electrodes to measure the electrical activity of the heart
  • Cardiac computed tomography (CT) scan, which takes pictures of the heart using X-ray waves
  • Magnetic resonance imaging (MRI), which takes pictures of the heart using a machine with a large magnet
Treatment

Pericarditis often improves without treatment. In some cases, it may be necessary to treat the underlying infection with prescription medication. More severe cases of pericarditis may require interventional or surgical treatment.