Tonsillitis: sore throat - heart pain

The connection between sore throat and heart pathology

Tonsillopharyngitis is the most common infectious disease of the oropharynx, in which the mucous membrane of the tonsils becomes inflamed. Often suppuration of the adjacent tissues develops, and if tonsillitis is caused by beta-hemolytic streptococcus and there are no antibiotics in the treatment regimen, the patient's condition is complicated by acute rheumatic fever or glomerulonephritis.
Pain in the heart area with angina is an optional symptom; it appears after two to three weeks. This sign indicates the need to consult a doctor for differential diagnosis of rheumatism and prescribing initial therapy.

Rheumatic fever in 3% of cases appears after tonsillopharyngitis of streptococcal etiology. It damages the connective tissue of blood vessels and joints, sometimes producing antigens to cardiac muscle cells (cardiomyocytes). The heart is affected on average in 50-80% of newly ill patients and in 100% of patients with a repeated episode of fever.

The above mechanisms lead to the development of inflammatory processes that cause necrosis (death) of parts of the heart, after which scars form on the walls of the chambers and valves. Subsequently, the mechanism of blood transport through the cardiovascular system is disrupted. A person feels a rapid heartbeat and shortness of breath due to a lack of oxygen supply to the organs.

Causes of sore throat

Sore throat is a disease that is caused by pathogens entering the oral cavity or nasopharynx. Such pathogenic microorganisms are strepto-, staphylo- and other cocci, also Haemophilus influenzae, Yersinia, spirochetes, corynebacteria. The following viruses can also provoke an inflammatory process:

1. Flu;
2. Monoculosis;
3. Herpes;
4. Rhinovirus;
5. Parainfluenza;
6. Enterovirus;
7. Adenovirus;
8. Respiratory syncytial.

All pathogenic bacteria settle on the tonsils and the back wall of the larynx and provoke an inflammatory process, causing an increase in the size of the tonsils and their redness. Symptoms of the disease include painful swallowing of food and liquid, the appearance of follicles with purulent content. Usually bacteria are present on the skin and mucous membrane of a person and are opportunistic, which in small quantities do not cause a painful condition. But in a number of situations, microbes begin to increase in number and provoke a sore throat, and then complications on various organs.

The following reasons are identified due to which opportunistic bacteria begin to attack the body, provoking a pathogenic condition - sore throat:

1. Long stay of the patient in a cool draft, sitting under an air conditioner set to cool;
2. Hypothermia of the body in the larynx or the entire body;
3. Staying in low temperature water for a long time;
4. Reduced defensive reaction;
5. Immune system diseases;
6. Development of a pathological condition of chronicity of the cardiovascular and endocrine systems;
7. Eating cold food or cold drinks, especially dairy products;
8. Laryngeal injury;
9. Impact of allergens on the mucous membrane of the larynx.

There are certain complications that are possible after a severe form of tonsillitis:

1. Edema of the larynx;
2. Abscesses;
3. Inflammatory process of the middle ear;
4. Phlegmon;
5. Blood poisoning;
6. Meningitis;
7. Brain abscess;
8. Pericarditis;
9. Appendicitis;
10. Rheumatism;
11. Glomerulonephritis.

If there is no therapeutic effect for a long time or the patient refuses to follow the doctor’s instructions, then angina in the acute stage is accompanied by complications. The acquisition of a secondary pathology is affected by incorrectly selected therapy, a weakening of the immune system, and a decrease in reactivity indicators. The outcome of the disease is influenced by antibiotics, which are stopped when the first signs of improvement are detected.

Danger to the heart muscle

The first signs of a developing heart complication after a previous sore throat appear after 3-4 weeks. Inflammatory processes are provoked by the acute phase of angina, which flows into the chronic stage.

After a severe course of infection with pathogenic microorganisms, certain complications arise:

1. Rheumatism;
2. Myocarditis;
3. Pericarditis is a pathological disease of the layers of pericarditis of the parietal type and visceral nature;
4. Changes in the normal functioning of myocardial valves, provoking the formation of defects;
5. Thromboembolism;
6. Arrhythmia.

The most dangerous complication in some cases after tonsillitis is swelling of the larynx, which blocks the routes of food entering the body and disrupts the normal course of the respiratory process.

These complications usually affect children under 3 years of age or adult patients who have crossed the age line of 40 years.

Signs of emerging complications

With mild complications of the heart after a sore throat, the symptoms are almost painless. The following signs are present:

1. Dyspnea;
2. The occurrence of painful discomfort behind the chest after lifting weights or physical activity;
3. Rapid pulse;
4. Heartache;
5. The neck veins gradually swell and begin to bulge;
6. Swelling of the extremities, especially the legs, is recorded after a day of work;
7. Tachycardia;
8. Constant lethargy, fatigue and desire for rest;
9. On an ultrasound examination, the doctor detects a violation of the volume of the myocardium, expansion is recorded;
10. While listening to the chest, murmurs are detected.

In the absence of a clinical picture, the consequences for a person can be disastrous: the disease does not reveal itself, but gradually worsens the patient’s general condition.

When serious complications occur in young children, the following symptoms are detected:

1. Shortness of breath, recorded not only when the child is active, but also during rest;
2. Temperature increase;
3. Chills and fever;
4. Hemoptysis;
5. Possible fainting;
6. Intense headache.

About the spread of the pathology of rheumatism, painful sensations are observed when bending the elbow and knee joints, discomfort in the digestive organs, and characteristic rashes on the skin. The heart muscle suffers already during the first attacks of ongoing rheumatic carditis, and during subsequent attacks its functioning is completely disrupted. Over time, the disease develops into heart defects.

If heart complications are not diagnosed in time after a sore throat, then there is no hope for their successful cure. It is impossible to independently determine the occurrence of pathology; to identify a secondary disease, you should undergo diagnostics.

People who are susceptible to frequent pathological processes developing in the tonsils or throat are advised to more diligently monitor their health and monitor the functioning of the main human organ.

Symptoms of complications on the myocardium always appear clearly. If you notice signs of abnormal heart function, you should immediately consult a doctor for diagnosis.

In addition to myocarditis, there is a possibility of developing endocarditis. Symptoms of its manifestation include bleeding of both external and internal types, fever, weakness in the limbs, an increase in high body temperature, the formation of heart failure, thickening of the phalanges of the fingers and swelling of the limbs.

As the pathology progresses, pain in the heart region is detected. They can vary in intensity and duration. If there is no therapeutic effect when complications develop, there is a possibility of inflammation spreading to the brain and kidneys, which ultimately leads to death. Types of complications

When a sore throat ends, complications developing in the heart can be detected almost immediately. There is a possibility of late consequences. What consequences occur after tonsillitis, and at what week they can be determined are presented in the table.

Treatment of any resulting consequences is recommended immediately at the time symptoms are identified. For therapeutic effects, a course of medication, traditional medicine recipes, as well as physiotherapy procedures are suitable.

The process of identifying pathologies

To detect a pathological condition after a previous sore throat, it is necessary to undergo a series of instrumental examinations, as well as an additional examination by a therapist. To accurately determine the relationship between a previous sore throat and a developed disease associated with the heart muscle, an additional survey and collection of symptoms are carried out.

To identify heart complications, the following examinations are required:

1. Ultrasound examination of the heart;
2. Electrocardiography;
3. Magnetic resonance or computed tomography;
4. Radiography;
5. Analysis to detect rheumatoid factor;
6. Functional and load testing;
7. Radioisotope scanning.

It is required to undergo tests, both general and biochemical, to examine the patient’s lymph and identify the inflammatory process. If pathological situations are detected in the heart area, then general complications are indicated by certain pathologies in the structure of the internal organs.

With the development of myocarditis, changes appear in the heart rate and heart rhythm is disturbed. The disease is also characterized by an increase in the volume of the heart muscle and heart cavities. Increases in C-reactive protein, gamma globulins and sialic acid are often detected in the blood.

The occurrence of rheumatism is indicated by such laboratory technician comments as an increase in the titer of streptococcal antibodies in the lymph and the identification of positive results after bacteriological culture.

With mitral valve stenosis, “cat purring”, diastolic chest noise, and right bundle branch block are often detected. Growth of the right ventricle and left atrium, and a decrease in the size of the mitral orifice are detected. The boundaries of the myocardium shift to the right and upward. The first heart sound becomes clapping. Changes in myocardial size and rhythm changes are recorded.

When this type of pathological condition is identified, the doctor immediately prescribes a therapeutic intervention.

Prevention of complications

The best treatment is prevention. Since tonsillitis is an infectious disease, people should avoid contact with patients, and if this is unavoidable, they recommend using personal masks and individual cutlery. At the same time, it is ineffective to strengthen the body’s defenses with antiviral drugs, take vitamins or other medications to improve immunity, since the etiology of the disease is more often of bacterial origin.

Great importance is given to vaccination, rational hours of work and rest, and an adequate indoor microclimate.

If you cannot avoid a sore throat, immediately consult a doctor to confirm the diagnosis and prescribe subsequent therapy. When tonsillitis is diagnosed, antibiotics are required, because getting rid of complications from the cardiovascular system without them is much more difficult. To do this, adhere to the prescribed treatment, regimen and nutrition. It is forbidden to stop taking medications without permission, ending the use of antibiotics when the condition improves, since the disease leads to complications.

Tonsillopharyngitis is taken seriously. After an infection, in the first days, beware of hypothermia and stress, since the body has not yet had time to get stronger.

Streptococcal shock

Streptococcal toxic shock is one of the most dangerous complications of tonsillitis. Occurs due to severe poisoning of the body with streptococcal toxins. The mortality rate when it occurs is about 30%, although it itself is quite rare.

The main symptoms of streptococcal shock are severe fever and breathing problems, and various skin rashes are common. The causes of death are usually shock and respiratory failure. At the same time, the disease can develop at different speeds, sometimes at lightning speed, and the patient simply does not have time to be taken to the hospital.

It is also useful to read: What is the danger of smoking with a sore throat and is it even possible to smoke with this disease?

Treatment is usually carried out in the intensive care unit. The patient requires artificial ventilation of the lungs, the use of vasoconstrictors, and intensive antibacterial therapy (with this, clindamycin is often used, since it suppresses the production of toxins faster than penicillins). Timely diagnosis of this complication is critical: sometimes a delay of several hours is fatal. Therefore, if you have any complaints about breathing problems, the patient should be taken to the doctor.

A patient with streptococcal shock in intensive care

The sooner treatment with antibiotics is started for a sore throat, the less likely it is to develop streptococcal shock, since over time bacterial toxins accumulate in the body and when a certain limit (individual for each person) is exceeded, shock develops.

conclusions

Cardiomyalgia (pain in the heart muscle) is just a set of symptoms that may not be life-threatening. But we cannot ignore such situations. In any of these cases, go to the doctor to prescribe additional tests and further treatment.

After suffering from a sore throat, pain in the heart in half of the cases indicates the development of complications. The likelihood of diagnosing rheumatism or rheumatic fever is especially high if there is no rational antibiotic therapy on the list of prescriptions. In order to prevent such problems, it is important to follow the doctor’s recommendations regarding adherence to the regimen and taking prescribed medications.

How does angina affect the heart?

Infection of the tonsils and pharynx can result in damage to different parts of the heart.

Often, pain in the heart is recorded during acute tonsillitis. Pathogens adhere to the endocardium due to weak immunity, structural abnormalities of the heart valves, and hemodynamic dysfunction caused by structural defects. The heart often hurts with a sore throat due to intoxication and general weakening of the body due to infection and high fever.

Late complications of tonsillitis develop when the disease seems to be over. Sometimes they occur a month or more after recovery. The appearance of heart pain during illness requires urgent diagnosis.

Late complications may include:

• inflammation of the connective tissues of the heart;
• rheumatic carditis;
• myocarditis;
• endocarditis;
• rhythm disturbances;
• pericarditis;
• valve dysfunction.

Cardiac complications of tonsillitis are more common in young people (under 40 years of age).

Information: in addition to cardiac dysfunction, inadequate therapy for tonsillitis can cause infection of other ENT organs, eyes, abscesses and phlegmon of the mucous membranes of the throat. With systemic influence, in addition to the cardiac structures, the kidneys, joints, and blood vessels are affected.

How does a rheumatic attack end?

In the classic picture of rheumatic heart disease, in the acute phase there are lesions of all 3 components of the heart wall. With proper treatment and rehabilitation, a complete recovery is possible, otherwise long-term complications may occur.

What consequences can result from an attack of acute rheumatic fever as a complication of a sore throat?

The most common is acquired valve disease. The valve gradually collapses, insufficiency and/or stenosis develops, and the heart does not function properly. The only treatment is valve replacement.

Video: Closed aortic valve replacement

Thromboembolism is more rare, but no less dangerous. Parts of the damaged valve come off and enter the bloodstream, resulting in thrombosis of veins and arteries of various sizes.

The most dangerous are:

• PE (pulmonary embolism),
• ileofemoral thrombosis,
• ischemic cerebral infarction (stroke)
• myocardial infarction,
• mesothrombosis.

Is it possible to die from these pathologies? These conditions lead to loss of health and disability in adults, and often to death.

Rheumatic heart disease

The heart consists of 3 layers of tissue:

• The endocardium is the lowest inner layer. Connective tissue lines the cavities of the heart, forming valves and chords.
• The myocardium is the muscular core of the heart, covered internally with endocardium and externally with pericardium.
• The pericardium is a sac of the heart, inside of which there is a pericardial cavity.

Each of these layers is involved in inflammation in rheumatic heart disease, but the process begins with damage to the endocardium - from the layer for which BSGA has an affinity.

Rheumatic endocarditis has no obvious symptoms, the heart does not hurt. Inflammatory granulomas are located at the edges of the valves; the growth and spread of lesions leads to the gradual destruction of the valve leaflets and hemodynamic disturbances.

Valve insufficiency manifests itself in regurgitation (backflow of blood) during heart contractions, resulting in a specific murmur. By the nature and distribution of the noise, you can determine which valve is affected.

Myocarditis is manifested by pain in the heart, decreased contractility (ejection fraction falls) - shortness of breath develops, patients take a forced half-sitting position, there may be loss of consciousness, cyanosis of the lips, blueness and paleness of the skin.

Do people die from rheumatic myocarditis? Yes, without proper treatment, heart failure develops and death is possible.

The pericardium is least involved in inflammation in rheumatism. In the acute phase, there may be damage to the inner layer with the production of a large amount of inflammatory exudate - fluid accumulates in the cavity of the heart sac, this impedes the ability of the heart to contract - shortness of breath, heaviness, pain and heart failure occur as a consequence of angina.

How to prevent complications from developing

Complete and timely treatment of sore throat helps prevent most complications. Therapy should include:

• bed rest throughout the illness;
• taking antibiotics or other drugs that suppress pathogenic flora;
• strict adherence to dosages and prescribed course;
• home remedies can only be auxiliary in the treatment of sore throat;
• drinking plenty of fluids and gargling with antiseptic solutions.

For coccal tonsillitis, bicillin prophylaxis helps to avoid complications. The administration of bicillin (antibiotic penicillin), which has a long period of action, helps prevent re-infection and reduce the risk of developing concomitant cardiac pathologies.

After completing treatment, you must adhere to the recommended regimen - avoid high stress, sports, hypothermia and contact with infected people. The recovery period after tonsillitis can take 1-3 months.

In the future, maintaining immunity at a high level helps to avoid infection; if it does occur, the disease is mild and does not have side effects on the heart. Therefore, hardening, a healthy lifestyle, and playing sports provide protection against sore throat and its consequences.