What is endocarditis?
Endocarditis is an inflammation of the inner lining of your heart, called the endocardium. It is usually caused by bacteria. When the inflammation is caused by an infection, the condition is called infective endocarditis. It is rare in people with healthy hearts.
Symptoms of endocarditis
If you develop endocarditis, you may have sudden symptoms, or you may develop them over time. How you feel depends on the health of your heart and the cause of the infection. Symptoms can also vary from person to person, but it is possible that.
Feel like you have the flu. You may develop a fever, chills, and night sweats. You may also feel pain in your muscles and joints. You have a new heart murmur. It can cause a new or extra heart murmur, an unusual sound in your heartbeat, or changes in an existing one.
Observe changes in your skin. Small bumps or spots may appear on your hands or feet. You may also see spots on the whites of the eyes or on the roof of the mouth due to broken blood vessels. Your skin may be pale. You feel nauseous. You may lose interest in food, feel sick to your stomach, or vomit.
You have pain on the left side of your body below your rib cage. This may be a sign that your spleen is trying to fight the infection. See blood in your urine. You may be able to see it on your own, or your doctor can see it under a microscope. You have swelling. Your abdomen, legs, or feet may have swelling.
It can happen when bacteria or fungi enter the body due to an infection, or when normally harmless bacteria that live in the entrance, upper respiratory tract, or other parts of the body attack heart tissue. Normally, the immune system can destroy these unwanted microorganisms, but any damage to the heart valves can allow them to adhere to the heart and multiply.
Clusters of bacteria and cells, or vegetation, form on the heart valves. These lumps make it hard for the heart to work properly. They can cause heart muscle and valve abscesses, damaged tissues, and cause electrical conduction abnormalities. Sometimes a cluster can break off and spread to other areas, such as the kidneys, lungs, and brain.
A dental problem or procedure that results in an infection can activate it. Poor tooth or gum health increases the risk of it, as this makes it calmer for bacteria to enter. Good dental hygiene helps prevent heart infections. Other surgical procedures can let bacteria enter, including tests to examine the digestive tract, for example, a colonoscopy. Procedures that affect the respiratory tract, urinary tract, including kidneys, bladder and urethra, skin, bones, and muscles, are also risk factors.
A heart defect can increase the risk of emerging endocarditis if bacteria enter the body. This can include a birth defect, an abnormal heart valve, or damaged heart tissue. People with an artificial heart valve are at higher risk.
A bacterial infection in another part of the body, for example, a skin sore or gum disease, can cause the spread of bacteria. Vaccinating drugs with dirty needles is a risk factor. Anyone who develops sepsis is at risk for it.
Sexually transmitted infections (STIs), such as chlamydia or gonorrhea, make it easier for bacteria to enter the body and reach the heart. A yeast infection can cause endocarditis.
Inflammatory bowel disease (IBD) or any bowel disorder can also increase the risk, but the risk of a person with IBD developing endocarditis remains low. Surgical or medical instruments used in treatment, such as a urinary catheter or long-term intravenous medications, can increase the risk.
Risk factors of endocarditis
If you have a healthy heart, you are unlikely to develop it. You are more likely to get it if you have heart problems or artificial heart valves, as this is where germs that cause infections can stick and multiply.
Your chances of developing endocarditis are higher if you have damaged or artificial heart valves, or if you were born with a heart defect. You are also more likely if you have used IV medications or had it in the past. Chambers and valves of the heart. Heart valves and chambers Open pop up dialog
You are more likely to develop endocarditis if you have defective, diseased, or damaged heart valves. However, endocarditis occasionally occurs in previously healthy people.
You are at an increased risk of endocarditis if you have:
Advanced age: It occurs most often in adults older than 60 years.
Artificial heart valves: Germs are more likely to attach to an artificial heart valve (prosthesis) than to a normal heart valve.
Damaged heart valves: Certain medical conditions, such as rheumatic fever or infection, can damage or scar one or more of the heart valves, increasing the risk of infection.
Congenital heart defects: If you were born with sure types of heart defects, such as an irregular heart or abnormal heart valves, your heart may be more vulnerable to infection.
Implanted heart device: Bacteria can adhere to an implanted device, such as a pacemaker, causing an infection of the lining of the heart.
History of endocarditis: It can damage heart tissue and valves, increasing the risk of future heart infection.
History of illegal intravenous drug use: People who use illegal drugs by injecting them are at increased risk of it. Needles used to inject drugs can be contaminated with bacteria that can cause endocarditis.
Poor dental: health A healthy mouth and gums are essential for good health. If you don’t brush and floss regularly, bacteria can grow inside your mouth and can enter your bloodstream through a cut in your gums.
Long-term catheter use: Having a catheter in place for a long time (indwelling catheter) increases the risk of it.
If you are at risk for endocarditis, tell all your doctors. You may want to order an endocarditis wallet card from the American Heart Association. Checkered with your local chapter or print the card from the association’s website.
Diagnosis of endocarditis
The diagnosis of bacterial endocarditis is based on the attendance of symptoms, the results of a physical inspection, and the results of diagnostic tests:
Blood cultures show bacteria or organisms commonly found with endocarditis. Blood cultures are blood tests that are taken over time that allow the laboratory to isolate the specific bacteria that are causing the infection. Blood cultures should be taken before starting antibiotics to ensure diagnosis.
An echocardiogram (ultrasound of the heart) may show developments (vegetations on the valve), abscesses (holes), new regurgitation (leak) or stenosis (narrowing), or an artificial heart valve that has begun to separate from the heart tissue. Sometimes doctors insert an ultrasound probe into the esophagus or “feeding tube” (transesophageal echo) to get a more detailed view of the heart.
Other signs and symptoms of bacterial endocarditis include:
- Emboli (small blood clots), bleeding (internal bleeding), or stroke
- Difficulty breathing
- Night sweats
- Lack of appetite or weight loss.
- Muscle and joint pain
Treatment of endocarditis
You may need to be in the hospital to receive antibiotics through a vein (intravenous). Blood cultures and tests will help your provider choose the best antibiotic. Then you will need long-term antibiotic therapy.
- People usually need therapy for 4 to 6 weeks to kill all bacteria in the heart’s chambers and valves.
- Antibiotic treatments that are started in the hospital should be continued at home.
Surgery to substitute the heart valve is often needed when:
- The infection is breaking into small pieces, resulting in strokes
- The person progresses to heart failure as a result of damaged heart valves
- There is an indication of more severe organ damage
Complications of endocarditis
In endocarditis, clumps of germs and cell fragments form an abnormal mass in your heart. These clumps, called vegetations, can break off and travel to your brain, lungs, abdominal organs, kidneys, or arms and legs.
As a result, endocarditis can cause numerous complications, including:
- Heart problems, such as a heart murmur, damage to the heart valves, and heart failure
- Pockets of accumulated pus (abscesses) that develop in the heart, brain, lungs, and other organs
- A blood clot in a pulmonary artery (pulmonary embolism)
- Kidney damage
- Enlarged spleen
Prevention of endocarditis
You can take the following stages to help prevent endocarditis:
- Know the signs and symptoms of endocarditis: See your physician right away if you develop any signs or symptoms, especially a fever that won’t go away, unexplained fatigue, any type of skin infection, or open wounds or sores that don’t heal properly.
- Take care of your teeth and gums: Brush your teeth and gums, floss, and get regular dental checkups. Good dental hygiene is a central part of maintaining your overall health.
- Don’t use illegal IV drugs: Dirty needles can send bacteria into the bloodstream, increasing the risk of endocarditis.
Certain medical and dental procedures can allow bacteria to enter the bloodstream. If you are at high risk for endocarditis, the American Heart Association recommends taking antibiotics one hour before having any dental work.
You are at high risk for endocarditis and need antibiotics before dental work if you have:
- History of endocarditis
- An artificial heart valve (mechanical prosthetic)
- A heart transplant, in some cases
- Certain types of congenital heart disease
- Congenital heart disease surgery in the past six months
- If you have endocarditis or any kind of congenital heart disease, talk to your physician and dentist about your risks and whether you need preventive antibiotics.