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Endocarditis

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  3. Endocarditis

Overview of Endocarditis

Bacteria are everywhere in the environment; some live on the surface of our skin while some enter our body via mouth, nose, or bruised skin and start to reside inside the body. If the bacteria present in the bloodstream infect the heart’s inner lining then it causes inflammation which is called Endocarditis (دل Ú©ÛŒ اندرونی پرت Ú©ÛŒ سوزش).

The inflammation of the heart lining is caused by a bacterial infection therefore it is also known as bacterial endocarditis or infective endocarditis. Infective endocarditis grows in a vegetative manner on the heart valves and makes holes in them by secreting toxic enzymes that damage the heart tissues. Complications caused by the leaky or blocked valve are a serious concern and can lead to death if remain untreated.

A person with a healthy heart is less susceptible to endocarditis. The reason is that the normal valve of the heart is resistant to bacterial infection. While if someone has a weak or diseased heart, the risk of endocarditis is there.

Signs and Symptoms of Endocarditis

Signs and symptoms develop over time and are often mild. Most of the symptoms resemble other illnesses therefore endocarditis remains undiagnosed in many cases.

Symptoms might vary in individuals, but you may feel some of the following:

  • Flu, fever, night chills, and sweats
  • Unusual heart murmur (an abnormal sound of heartbeat)
  • Nausea and vomiting
  • Skin rash
  • Decreased appetite and stomach sickness
  • Pain under the left side of the rib cage (due to the enlarged spleen)
  • Urinary blood
  • Weight loss
  • Pale skin with bumps and spots on hands and feet
  • Sore throat, dry or moist cough
  • The wound that won’t heal
  • Pain, redness, or swelling

Types of Endocarditis

Causes of Endocarditis

The overgrowth of bacteria is considered the leading cause of endocarditis. However, some fungal species are also involved in the development of endocarditis. Our body has natural microflora. But when either bacterial growth in our body becomes out of control or pathogens enter our body, it leads to various problems.

Eating contaminated food and drinking impure water is a major source of getting harmful bacteria inside our bodies. Once the bacteria enter the body, the natural defense mechanism (immune system) activates to start fighting the germs. People with weak immunity are unable to resist bacterial infection.

Besides eating and drinking some other sources of bacterial invasion in the body are:

  • Gum disease and poor oral hygiene
  • Reused syringes (contaminated needles)
  • Indwelling intravenous or urinary catheter
  • STI (sexually transmitted Infections)
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Risk Factors of Endocarditis

You are more likely to suffer from endocarditis if you have damaged, diseased, or faulty heart valves. But everyone can suffer from endocarditis. 

Your chances of suffering from endocarditis increase if you have:

  • Older Age- If you are above 60 years of age, your risk of endocarditis increases.
  • Damaged Heart Valves- Rheumatic fever or infection can scar or damage your heart valves, increasing the risk of the infection. 
  • Artificial Heart Valves- Artificial heart valves are more prone to the attack of germs.
  • Implanted Heart Device 
  • Congenital Heart Defects
  • Poor Oral Hygiene
  • History of Endocarditis
  • History of Using Illegal IV Drug
  • Long-term Use of Catheter

Complications of Endocarditis

In endocarditis, abnormal mass is accumulated in the heart by the clumps of cell pieces and germs. These are vegetative clumps. These clumps can break and travel to the lungs, brain, kidneys, abdominal organs, legs, and arms.

Due to this endocarditis can lead to several complications such as:

  • Heart Issues such as damaged heart valve, heart murmur, and heart failure.
  • Abscesses (pockets of the collected pus) develop and get accumulated in the lungs, heart, brain, and other organs.
  • Enlarged spleen
  • Kidney damage
  • Pulmonary embolism (blot clot in a lung artery)

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Prevention

If you are at a higher risk of developing endocarditis it is extremely essential that you limit any trigger, especially your exposure to any bacterial infection. The same is the case if you have been previously affected by endocarditis. 

Following are some ways that you need to opt to reduce your risk of endocarditis:

  • Practice Good Oral Hygiene- You need to take care of your oral hygiene. Don’t let gum disease or abscesses go untreated. Visit your dentist regularly to ensure you are having good oral health. 
  • Take Good Care of Your Skin- You need to keep your skin clean. Use antibacterial soap to wash your hands and body to reduce the chances of developing any skin infection. But do not use it on your face. If you have any skin condition you need to consult your general practitioner to have a skincare routine accordingly. 
  • Medication- If you are taking any medication such as antibiotics for endocarditis, do not skip them. Research shows that antibiotics are good for preventing endocarditis. 
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Diagnosis

Diagnosis of endocarditis includes a physical examination of the heartbeat using a stethoscope and asking about previous medical history.

Diagnostic tests that are conducted to diagnose endocarditis are:

  • Symptoms of infections as mentioned above especially fever over 38.4 degrees celsius. 
  • Blood Cultures are obtained to check the presence of microorganisms or bacteria causing  
  • Electrocardiogram or ECG (to determine the rate of the heart’s electrical activity).
  • Chest X-ray (to analyze the functioning of lungs and for differentiating endocarditis from other diseases)
  • Transthoracic echocardiogram (to see abnormal heart movements by using ultrasound waves)
  • Transesophageal echocardiogram (a test used to view the heart from the esophagus when additional information is needed.)
  • Blood culture test (To identify the causative agent: bacteria or fungi)

Treatment of Endocarditis | When to Consult a Doctor

Endocarditis is treated by two methods i.e. Antibiotics and Surgery.

  • Antibiotics are used when an infection is caused by bacteria. The doctor will go for intravenous antibiotic therapy until the inflammation is reduced. It may take a week or more. Later on, treatment will be done using oral antibiotics.

  • Surgery is required to treat prolonged endocarditis. Damage to the heart valve is minimized by removing debris, scar tissue, dead tissues, and fluid from infected tissues. In severe conditions damaged heart valves are replaced with animal tissue or any other synthetic material.

If you are observing persistent changes in your skin, appetite, and weight, and are doubtful about an abnormal heartbeat. It is highly recommended to consult the cardiologist immediately without any delay. 

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