multi class comparison

Cardiac Inflammation: Endocarditis vs Pericarditis vs Myocarditis — Layer, Presentation, Complication

All three are "cardiac inflammation," but the wrong layer changes everything — embolic stroke versus tamponade versus sudden heart failure. The NCLEX gives you a cluster of findings and expects you to match it to the correct -itis in seconds. Mixing them up means choosing an intervention that misses the life threat.

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Comparison

Side-by-side3 compared
Comparevs
Dimension
Endocarditis
Pericarditis
Myocarditis
Layer & cause
  • Endocardium/valve lining
  • S. aureus, S. viridans
  • IV drug use, prosthetic valves
  • Pericardium (outer sac)
  • Viral, post-MI (Dressler), uremia
  • Myocardium (heart muscle)
  • Viral (coxsackie, COVID-19)
  • autoimmune
Hallmark presentation
  • ★Janeway lesions, Osler nodes, splinter hemorrhages
  • Fever
  • new regurgitant murmur
  • ★Sharp pleuritic pain, eased leaning forward
  • Worse supine and with deep breath
  • ★New HF in young, previously healthy pt
  • Follows viral illness
  • vague chest pain
Diagnostics & ECG
  • Blood cultures ×3 before antibiotics
  • Echo shows valve vegetations
  • ★Diffuse concave ST elevation + PR depression
  • ↑ ESR/CRP
  • echo for effusion
  • ↑ Troponin/CK-MB
  • echo shows ↓ EF
  • Endomyocardial biopsy definitive
Auscultation & monitoring
  • Neuro checks q1–2h for embolic stroke
  • Trend fevers
  • IV antibiotics 4–6 wk
  • Pericardial friction rub (scratchy)
  • Watch tamponade: pulsus paradoxus >10
  • S3 gallop
  • continuous telemetry, daily weights
  • Activity restriction
  • watch HF decline
Treatment
  • Prolonged IV antibiotics 4–6 weeks
  • Valve surgery if vegetation/failure
  • NSAIDs + colchicine for inflammation
  • Pericardiocentesis for tamponade
  • Supportive HF therapy
  • treat cause
  • Manage dysrhythmias
  • rest the heart
Patient teaching
  • Antibiotic prophylaxis before procedures
  • Report fever, new emboli signs
  • Sit up / lean forward eases pain
  • Finish full NSAID/colchicine course
  • Restrict exertion during recovery
  • Report worsening dyspnea or edema
Red flags — escalate
  • New stroke / limb ischemia then embolism
  • ★Beck triad: JVD, muffled tones, ↓BP
  • VT or heart block then fatal dysrhythmia
Complications
  • Septic emboli: stroke, splenic/renal infarct
  • Effusion then cardiac tamponade
  • Dilated cardiomyopathy
  • sudden cardiac death
Layer & cause

Endocarditis

  • Endocardium/valve lining
  • S. aureus, S. viridans
  • IV drug use, prosthetic valves

Pericarditis

  • Pericardium (outer sac)
  • Viral, post-MI (Dressler), uremia
Hallmark presentation

Endocarditis

  • ★Janeway lesions, Osler nodes, splinter hemorrhages
  • Fever
  • new regurgitant murmur

Pericarditis

  • ★Sharp pleuritic pain, eased leaning forward
  • Worse supine and with deep breath
Diagnostics & ECG

Endocarditis

  • Blood cultures ×3 before antibiotics
  • Echo shows valve vegetations

Pericarditis

  • ★Diffuse concave ST elevation + PR depression
  • ↑ ESR/CRP
  • echo for effusion
Auscultation & monitoring

Endocarditis

  • Neuro checks q1–2h for embolic stroke
  • Trend fevers
  • IV antibiotics 4–6 wk

Pericarditis

  • Pericardial friction rub (scratchy)
  • Watch tamponade: pulsus paradoxus >10
Treatment

Endocarditis

  • Prolonged IV antibiotics 4–6 weeks
  • Valve surgery if vegetation/failure

Pericarditis

  • NSAIDs + colchicine for inflammation
  • Pericardiocentesis for tamponade
Patient teaching

Endocarditis

  • Antibiotic prophylaxis before procedures
  • Report fever, new emboli signs

Pericarditis

  • Sit up / lean forward eases pain
  • Finish full NSAID/colchicine course
Red flags — escalate

Endocarditis

  • New stroke / limb ischemia then embolism

Pericarditis

  • ★Beck triad: JVD, muffled tones, ↓BP
Complications

Endocarditis

  • Septic emboli: stroke, splenic/renal infarct

Pericarditis

  • Effusion then cardiac tamponade

★ marks the fact that sets a column apart.

Clinical Pearl

Rub + lean forward = pericarditis; vegetations + emboli = endocarditis; new HF after flu = myocarditis.

Component Topics

Endocarditis, Pericarditis, Myocarditis

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