An Expert Tells You Everything About Endocarditis
A rare condition which involves inflammation of the innermost heart lining and heart valves is termed as endocarditis.It may occur when bacteria, fungi or other germs from other parts of your body during throat infections, teeth infections, urinary tract infection, etc, tend to spread through your bloodstream and may get attached to damaged areas in your heart. It is also called as infective endocarditis (IE), bacterial endocarditis (BE), infectious endocarditis, and fungal endocarditis. If you fail to treat it at the right time then it may damage or destroy your heart valves and you may also develop life-threatening complications. Thus, an infection of the endocardium leads to endocarditis, and the infection most commonly caused by streptococcal or staphylococcal bacteria, fungi in case of IV drug abusers.
What are the symptoms of Endocarditis?
One may develop endocarditis slowly or suddenly, depending on the germs that are causing the infection and if you have any underlying heart problems. People who already have mild to moderate forms of heart valve stenosis or valve leaks are more prone to develop endocarditis. Symptoms like fever, chills, fatigue, night-time sweating, breathing problems, muscle and joint pain, chest pain while breathing, swelling of the feet, legs or abdomen. Moreover, the symptoms may also vary from person-to-person. Other symptoms include unexplained weight loss, blood in the urine, tenderness in your spleen, and Osler's nodes, which are red, tender spots under the skin of your fingers or toes. Hence, when you spot the symptoms, you should immediately consult your doctor.
What are the causes of endocarditis?
- Bacteria may spread from an infected area like a skin sore. Other medical conditions, such as gum disease, a sexually transmitted infection or certain intestinal disorders like inflammatory bowel disease can allow the bacteria to enter your bloodstream, etc.
- Bacteria that cause endocarditis may enter your bloodstream through the needles used for the purpose of tattooing or body piercing.
- Contaminated needles and syringes can also be the culprits as there is a special concern for people who use illegal intravenous (IV) drugs like heroin or cocaine. Often, individuals who use these types of drugs don't have access to clean, unused needles or syringes.
- Some dental procedures which cut your gums may allow bacteria to enter your bloodstream.
What are the symptoms of endocarditis?
The treatment for endocarditis depends on many factors- your clinical condition, the severity of infection, the severity of heart valve lesion. In this case, you need to visit a cardiac specialist, who would conduct tests like 2 echocardiography, blood culture to diagnose the disease.
What is the treatment of endocarditis?
People with endocarditis may be prescribed antibiotics, these are administered intravenously or through a drip. Antibiotic treatment in endocarditis is lengthy. Even after the patients are discharged they are required to continue with antibiotics without fail. Furthermore, the patients need to do a regular follow-up with the doctor to keep themselves updated about the recovery. Hence, the patient should follow the doctor’s advice to get back on track. One should also avoid self-medication, and using over-the-counter medications.
Not only this, if endocarditis has damaged one’s heart, then one may require to undergo open heart surgery to correct the valve dysfunction caused by endocarditis. One will have to opt for surgery if the heart valve is damaged to an extent that it does not close tightly enough, and regurgitation occurs, where the blood flows back into one’s heart. If one continues to suffer from an infection and does not respond to antibiotic or antifungal medication, and also if there are large clumps of bacteria and cells, or vegetations, attached to a heart valve. Thus, surgery is the option to repair a heart defect or damaged heart valves.
The overall prognosis of infective endocarditis depends on the bacteria involved, the heart valve that’s involved, the sensitivity of the organisms to antibiotics, patient’s compliance with antibiotics.
How to prevent endocarditis?
You should be aware of the signs and symptoms of endocarditis. Consult your doctor immediately if you notice any signs or symptoms, especially a fever that won't go away, repeated admissions for fever, unexplained fatigue, skin infection, open cuts or sores that fail to heal. Moreover, avoid procedures which can raise your risk of skin infections like body piercings or tattoos. Keep yourself away from (IV) drug abuse since it can lead to serious right heart valve endocarditis which can be fungal in aetiology.
Dr Bipeenchandra Bhamre is a Cardio-Thoracic Surgeon at Sir H N Reliance Foundation Hospital and Research Centre, Mumbai.