Endocarditis is a relatively rare condition that affects the heart lining, heart valves, and heart muscles, and is also known as Infective Endocarditis. The condition is typically caused by an infection, such as bacterial, fungal, or other types of germs. The germs spread through the bloodstream from another part of the body and attach to the heart's inner lining, the endocardium, leading to Endocarditis.
If not treated promptly, Endocarditis can become severe and may damage or destroy heart valves, leading to potentially serious complications. Men are more commonly affected by this condition than women, and individuals aged 60 or older are at higher risk of developing Endocarditis. People with abnormal heart valves, prosthetic heart valves, or those with pacemaker leads are also more susceptible to this condition.
Symptoms of Endocarditis may appear suddenly, or they may develop gradually over time. However, effective treatment options such as medications are available, and in some cases, surgery may be necessary to manage the condition.
Infective endocarditis is classified into three types, namely: acute bacterial endocarditis, subacute bacterial endocarditis, and prosthetic valvular endocarditis. Acute bacterial endocarditis, which is usually caused by Staphylococcus Aureus bacteria, has a sudden onset and can cause damage to the heart valves. On the other hand, subacute bacterial endocarditis is caused by Streptococcal bacteria and develops on damaged valves over time, potentially leading to life-threatening symptoms. Lastly, prosthetic valvular endocarditis affects individuals who have undergone valve replacement or tissue valve replacement surgery, with the highest cases occurring among those who have received artificial aortic valves.
Endocarditis symptoms can appear suddenly or develop slowly over time and may be similar to other illnesses. Common signs and symptoms include joint and muscle pain, chest pain, fatigue, night sweats, shortness of breath, fever, headache, small painful lumps or nodules on the fingers, blood in urine, weakness, unexpected weight loss, tenderness in the spleen, and swelling in the legs, feet, or abdomen.
Endocarditis is typically caused by bacterial overgrowth, where certain bacteria that normally live in or on the body enter the bloodstream and infect the endocardium. These bacteria can form clumps or "vegetation" on heart valves, impacting heart function, and in some cases, breaking off and spreading to other parts of the body. Some common factors that increase the risk of developing endocarditis include dental problems, bacterial infections in other parts of the body, certain surgical procedures, sexually transmitted infections, and using contaminated needles for illegal intravenous drug use.
The healthcare provider may recommend several tests to diagnose endocarditis. These tests may include: Blood culture test: This test is performed to detect the presence of any bacteria or other germs in the bloodstream. The results of the blood culture test can help the doctor choose appropriate medications for treatment. Transthoracic echocardiogram: This test involves the use of a transducer, a wand-like device that produces sound waves, to create video images of the heart in motion. The transducer is placed on the chest to obtain the images. Transesophageal echocardiogram: This test provides a detailed view of the heart valves. A small transducer attached to the tip of a flexible tube is inserted into the mouth and passed down the esophagus to the heart. Electrocardiogram (ECG or EKG): This test measures the duration and timing of the heartbeats to evaluate the heart's electrical activity and identify any abnormalities. Chest X-ray: This test uses X-rays to examine the heart and lungs for signs of swelling, damage, or infection caused by endocarditis.
After a diagnosis of endocarditis, prompt treatment is crucial to prevent harm to the heart valves or complications. Treatment options depend on the type and severity of the condition. For bacterial endocarditis, the doctor may prescribe intravenous antibiotics, sometimes at high doses, requiring hospitalization for a week or longer to monitor progress. Once symptoms subside, the patient may continue on antibiotics for several weeks to eliminate the infection. In severe cases, the doctor may recommend heart valve surgery to repair or replace damaged valves, remove vegetation or debris, and drain fluids or dead tissue resulting from the infection.
Certain factors can increase the risk of developing endocarditis, such as age, previous history of endocarditis, congenital heart defects, artificial or damaged heart valves, implanted heart devices, tissue damage, scarring of heart valves, and poor dental health. Additionally, injecting illegal drugs using a contaminated needle can also increase the risk of developing endocarditis.
Maintaining good oral hygiene is an effective way to prevent endocarditis as it reduces the buildup of bacteria in the mouth that can enter the bloodstream. Recognizing the signs and symptoms of endocarditis and seeking prompt medical attention is also crucial for quick treatment.
Additionally, it is advisable to avoid certain activities that may increase the risk of developing endocarditis, such as getting tattoos, injecting illegal drugs intravenously, undergoing body piercings, or undergoing procedures that may allow germs to enter the bloodstream.