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Understanding Endocarditis: Symptoms, causes, and treatment

Team AckoJan 16, 2023

The heart usually is well protected against infection. However, if your heart valves are damaged, or you have an artificial valve, bacteria can take root and circumvent your body's natural immune reaction to infection. Endocarditis pertains to inflammation of the inner lining of the heart, which can be dangerous. Read on to learn about Endocarditis, its symptoms, causes, and treatment.

endocarditis

Contents

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What is Endocarditis?

Endocarditis is caused by bacteria in blood circulation proliferating and spreading over your heart's inner lining (endocardium). Here, the endocardium becomes inflamed, causing heart valve damage. At the location of the infection, little clusters of bacteria might form. These aggregates have the potential to behave similarly to blood clots, obstructing blood flow to the organs. This can result in organ failure or a stroke.

What causes Endocarditis?

Bacteria that cause infective Endocarditis enter the circulation and infect the heart. Staphylococcus aureus (staph infection) and Streptococcus (strep) bacteria are commonly associated with infective Endocarditis.

Typically, heart valves are very resistant to bacterial adhesion and infection. As the germs migrate swiftly through the damaged valve lining, bacteria that can most strongly cling to the surface have the highest chance of causing infective Endocarditis. Clumps of bacteria and cells known as vegetation grow on the heart valves, interfering with the heart's function. If left untreated, this vegetation may leak the valve and cause an abscess close to the valve or in the valve itself.

What are the common symptoms of Endocarditis?

The presenting symptoms are a persistent low-grade fever with no evident cause, exhaustion, and shortness of breath with exercise. Patients may also have joint and muscle discomfort, and their doctor may detect a new or altered murmur. Moreover, the following signs and symptoms can also appear:

  • A previously undetected heart murmur or a changing heart murmur

  • A fever of 100 to 103 degrees 

  • Chills and flu-like symptoms

  • Resting shortness of breath

  • Sweating at night

  • Pain in the chest during breathing

  • Foot, leg, or abdomen swelling

  • A fast heartbeat (tachycardia)

  • Weight loss due to appetite loss

  • Urine containing blood or blood cells (hematuria)

  • Tiny red dots on the eye conjunctiva and fingernails (splinter haemorrhages)

  • Small, painless patches on the palms or soles of the feet (Janeway lesions)

  • Nodules of pain in the fingers (Osler nodes)

Are there any associated complications?

Left untreated, Endocarditis can be life-threatening. Here are some complications. 

  • Infection of the heart valve causes tissue deterioration, valve leakage, and heart failure. 

  • An abscess with a rupture between distinct heart chambers may develop from infection spreading into the tissue around the valve. 

  • Clots (emboli) caused by infective Endocarditis can cause significant injury. Clots lodge in the brain in 20-40% of people with infective Endocarditis, causing weakness on one side of the body, loss of vision, or stroke. The location of the clot determines the symptoms. 

  • Clots can also induce stomach discomfort, flank pain, or extremities arterial insufficiency.

Are there any risk factors associated with Endocarditis?

Previous heart injury, recent heart surgery, or poor oral hygiene are the most frequent risk factors for infective Endocarditis. Various factors can make your heart more susceptible to infection and raise your risk of getting Endocarditis. Some conditions are:

  • Heart valve disease: It refers to health issues that affect the heart's valves. Heart valve disease can be congenital (you are born with the problem) or acquired (you develop the condition later in life and have artificial valves).

  • Aortic valve replacement surgery: It uses prosthetic (artificial) valves to replace heart valves destroyed by heart valve disease. Bacteria can grow around prosthetic valves, causing Endocarditis in some cases.

  • Drug-induced hypertrophic cardiomyopathy: The heart muscle cells grow, and the walls of the heart chambers thicken in hypertrophic cardiomyopathy. Because the chambers are smaller, they can't retain as much blood, and the walls can't relax correctly and may harden.

  • Congenital heart disease: Congenital heart illness is one of the most prevalent forms of congenital disabilities, with the most common being ventricular septal defect (VSD).

  • A previous history of Endocarditis studies reveals that individuals who once had Endocarditis are more likely to have it a second time.

  • Intravenous drug use with a contaminated needle.

Can Endocarditis be prevented?

The mouth is a crucial entry point for germs into the body, particularly Streptococcal species.

The American Heart Association suggests Penicillin prophylaxis for individuals with congenital heart disease and rheumatic heart disease before dental procedures like root canal therapy and extraction to reduce the chance of developing Endocarditis.

How is Endocarditis diagnosed?

Your doctor could recommend certain tests if you exhibit Endocarditis symptoms. A doctor will listen to your heart to check for any new or altered heart murmurs. Before rendering a diagnosis, they may request one or more of the following tests if they require further information:

  1. Blood test: These will check for germs in your circulation or reveal other Endocarditis-related conditions, such as anaemia, which denotes a lack of red blood cells.

  2. Electrocardiogram or echocardiography: These examinations demonstrate how your heart is functioning.

  3. X-ray: This will reveal if your heart or lungs have been impacted by Endocarditis.

  4. CT or MRI scan: These examinations utilise images to show your doctor whether the illness has moved to different parts of your body, such as your chest or brain.

How to treat Endocarditis

Early diagnosis and aggressive therapy are critical for the successful management of Endocarditis.

  • Antibiotics: A course of antibiotics can be used to treat Endocarditis patients. Before prescribing antibiotics, your doctor will often get a blood sample to ensure you receive the best antibiotics possible. If you are taking antibiotics at home, you should schedule routine visits with your doctor. Antibiotics often need to be taken for two to six weeks.

  • Your heart may suffer significant harm as a result of Endocarditis. Surgery can be required to fix cardiac damage in case your symptoms or test results point to heart failure, a critical illness in which your heart is not effectively pumping blood throughout your body. If you also have a fever after taking antibiotics. A cardiologist, who specialises in conditions of heart and blood vessel conditions, may be recommended to examine your heart.

Frequently Asked Questions (FAQs)

Here are some FAQs on Endocarditis.

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Is Endocarditis related to dental hygiene?

A key component of preventing Endocarditis is dental hygiene. Through circulation, germs from oral diseases can go to your heart and infect it. Be sure to routinely see the dentist, clean and floss your teeth, and take care of your gums.

What results in Endocarditis in humans?

Bacteria proliferating and spreading throughout the inside lining of your heart is what causes Endocarditis (endocardium). Your heart valves are harmed as a result of the endocardium being inflamed. In most cases, your heart is adequately protected against infection, allowing germs to pass through unharmed.

Can Endocarditis be totally recovered from?

The majority of patients with Endocarditis recover with vigorous therapy. If you suspect you may have Endocarditis, be aware of the signs and symptoms and reach out to your doctor.

Resources 

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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