Infections of the heart and how they relate to the ambulance service

Abstract

Abstract published with permission. Background: In the pre-hospital environment, the treatment of acute coronary syndrome (ACS) is at the forefront of most clinicians’ priorities when symptoms include non-traumatic chest pain. As ACS is a leading cause of preventable deaths, less emphasis is placed on other potentially life-changing conditions that are associated with non-traumatic chest pain. Objectives: This article discusses the three main groups of cardiac infections (pericarditis, myocarditis, and endocarditis). It then discusses how they can be identified in the pre-hospital setting and how the ambulance service can contribute to the subsequent diagnosis of patients presenting with these conditions. Discussion: Pericarditis is a relatively common cause of non-traumatic chest pain. It has symptoms that can be found in the pre-hospital environment such as specific ECG changes and symptoms that can be identified during an initial consultation. Myocarditis has a low incidence rate as well as a wide variety of symptoms that can be associated with other common ailments. It is a very hard condition to determine in the pre-hospital environment. Endocarditis in the intravenous drug user population is a significant condition and has a high mortality rate.