Endocarditis Definition
Endocarditis is an infection that occurs in the inner lining of the human heart (endocardium). This disease is dangerous and can be fatal.
Generally, endocarditis does not affect a healthy heart. Therefore, people with artificial heart valves, congenital heart disease, hypertrophic cardiomyopathy, and some other heart disorders are at risk of developing this disease.
People who frequently inject illegal drugs also have a greater risk of developing endocarditis.
Symptoms of Endocarditis
Some common symptoms of endocarditis include:
- Fever.
- Unexplained weight loss.
- Headache.
- Red spots under the skin on the fingers.
- Dazed ( mental confusion ).
- Blood in urine.
- Night sweats.
- Shortness of breath.
- Pale.
- Purple or red spots on the skin, whites of the eyes, or inside the mouth.
- Swelling in the feet, legs, or abdomen.
- Persistent cough.
- Pain in the joints, muscles and left waist under the ribs (infection spreads to the spleen).
- Changes in heartbeat sounds.
- Fatigue.
Causes of Endocardiatis
Endocarditis occurs when germs enter the bloodstream, then enter the heart and attach to abnormal heart valves or damage heart tissue.
Germs can enter a person’s bloodstream in various ways, including through:
- Catheters or syringes. Contaminated catheters and needles can be a portal of entry for germs.
- Infection or other medical conditions. Bacteria can enter the heart from another infected part of the body.
- Some dental procedures. Various dental procedures can cause injury to the gums and allow bacteria to enter the bloodstream.
- Daily oral activities. Activities such as brushing teeth and chewing food can cause bacteria to enter the bloodstream, especially if the condition of the teeth and gums is poor.
In most cases of endocarditis, bacteria are the cause.
However, a person can also suffer from endocarditis due to fungi and other microorganisms.
A person’s risk of developing endocarditis increases when the person has other heart valve disease, has an artificial heart valve, or has an abnormal heart valve.
This occurs because abnormal heart valves have the potential to become a place for bacteria to collect.
In addition, other causes include:
- Injecting drug users.
- Congenital heart defects.
- Have had endocarditis.
- Damage to the heart valve.
Endocarditis Risk Factors
Endocarditis disease can be experienced by anyone. However, some triggers below can increase a person’s risk of developing endocarditis, including:
- Having damage to the heart valves.
- Abuse of drugs and other addictive substances.
- Have had endocarditis before.
- Use of artificial heart valves.
- Having congenital heart disease.
Diagnosis of Endocarditis
To diagnose endocarditis, your doctor will perform a physical exam and ask questions about your health history and symptoms.
Tests your doctor can do to help confirm or rule out endocarditis.
Test
Tests that doctors use to help diagnose endocarditis include:
Blood culture test
This test helps identify germs in the bloodstream. The results of this test help determine which antibiotic or combination of antibiotics your doctor will use for treatment.
Complete blood count
This test can tell if there are too many white blood cells, which can be a sign of infection.
A complete blood count can also help diagnose low levels of healthy red blood cells (anemia), which can be a sign of endocarditis. Other blood tests your doctor may also order.
Echocardiogram
Sound waves are used to create images of the beating heart. This test shows how well the heart chambers and valves are pumping blood. It can also show the structure of the heart.
Doctors may use two different types of echocardiograms to help diagnose endocarditis.
In a standard (transthoracic) echocardiogram, a wand-like device (transducer) is moved over the chest area. It directs sound waves toward the heart and records them as they bounce back.
In a transesophageal echocardiogram, a flexible tube containing a transducer is guided down the throat and into the tube connecting the mouth to the stomach (esophagus).
A transesophageal echocardiogram provides a much more detailed image of the heart than a standard echocardiogram.
Electrocardiogram (ECG or EKG)
This quick, painless test measures the heart’s electrical activity.
During an electrocardiogram (ECG), sensors (electrodes) are placed on the chest and sometimes on the arms or legs.
It is not specifically used to diagnose endocarditis, but can show whether something is affecting the heart’s electrical activity.
Chest X-ray
A chest X-ray shows the condition of the lungs and heart. This test can help determine whether endocarditis is causing the swelling of the heart or whether the infection has spread to the lungs.
Computerized tomography (CT) scan or magnetic resonance imaging (MRI).
You may need a scan of your brain, chest, or other parts of your body if your doctor thinks the infection has spread to those areas.
Endocarditis Treatment
Many people with endocarditis can be successfully treated with antibiotics. Sometimes, surgery may be needed to repair or replace damaged heart valves and clear up any remaining signs of infection.
Drugs
The type of medication you receive depends on the cause of endocarditis.
High-dose antibiotics are used to treat endocarditis caused by bacteria.
If you receive antibiotics, you will usually spend a week or more in the hospital so providers can determine whether the treatment is working.
Once the fever and other severe symptoms are gone, you may be able to leave the hospital.
Some people continue antibiotics by visiting their doctor or at home with home care. Antibiotics are usually taken for several weeks.
If endocarditis is caused by a fungal infection, antifungal medications are given. Some people need to take antifungal pills for life to prevent recurrence of endocarditis.
Surgery or other procedures
Heart valve surgery or surgery may be needed to treat persistent endocarditis infection or to replace a damaged valve.
This procedure is sometimes necessary to treat endocarditis caused by a fungal infection.
Depending on the specific condition, your doctor may recommend heart valve repair or replacement.
Heart valve replacement uses a mechanical valve or a valve made from cow, pig, or human heart tissue (biological tissue valve).
Complications of Endocarditis
In endocarditis, irregular growths made of germs and cell fragments form masses in the heart. These clumps are called vegetations.
They can break free and travel to the brain, lungs, kidneys, and other organs. They can also travel to the arms and legs.
Complications of endocarditis may include:
- Heart failure
- Heart valve damage
- Stroke
- A pus-filled pocket (abscess) that develops in the heart, brain, lungs, and other organs
- Blood clot in the pulmonary artery (pulmonary embolism)
- Kidney damage
- Enlarged spleen
Endocarditis Prevention
Some preventive measures you can take include:
- Maintaining body hygiene, especially dental health. Also, avoid activities that can cause skin infection such as piercing and tattooing on body parts.
- Taking medication. Owners of artificial heart valves, people who have had endocarditis, people with certain heart disorders, and heart transplant patients who have heart valve dysfunction are advised to take medication before undergoing medical procedures to prevent endocarditis. This medication will be given as a prescription from a doctor.
