Endocarditis is an infection of the inner
lining of the heart (endocardium) or the heart valves. The
infection may damage or even destroy the heart valves.
How does it occur?
Endocarditis occurs when
bacteria in the bloodstream (bacteraemia) settle and grow on
abnormal heart valves or other damaged heart tissue. Certain
bacteria normally live on parts of the body, such as the
mouth and upper respiratory system, the intestinal and
urinary tracts, and the skin. Some surgical and dental
procedures cause a brief bacteraemia. Although bactaeremia
is common only certain bacteria like Streptococci commonly
cause endocarditis.
Who is at risk?
Endocarditis rarely occurs in people with
normal hearts. However, if they have certain preexisting
heart conditions, they are at risk for developing
endocarditis when a bacteremia occurs. Some of these
conditions include having:
an artificial (prosthetic) heart valve
a history of previous endocarditis
heart valves damaged by conditions such
as rheumatic fever
congenital heart or heart valve defects
What are the symptoms?
Endocarditis can cause a wide variety of
symptoms, particularly in the earlier stages of infection.
Patients may experience such general symptoms as fever,
chills, fatigue, weight loss, muscle aches, and sweating.
With such nonspecific symptoms it may be difficult for the
doctor to recognize endocarditis.
As the infection progresses, other symptoms may develop. If
the infection begins to damage the heart valve, the valve
may become “leaky.” A leaky heart valve can eventually lead
to blood backing up into the lungs. This accumulation of
fluid in the lungs can cause shortness of breath. If the
infection spreads to the kidneys, patients may notice blood
in the urine. If the infection spreads to the brain, it can
cause headaches, confusion, or even stroke.
How is it diagnosed?
A variety of tests including
blood culture, a complete blood count (CBC) or a CT ("cat")
scan of the chest, can be used to diagnose this disease.
Some cases are "culture-negative", meaning no fungus or
bacterium can be found.
What is the treatment?
Endocarditis is known to cause
severe morbidity (a diseased state) and even death in
patients. Antibiotics are recommended for the treatment of
endocarditis. The commonly used antibiotics include
amoxycillin, ampicillin, clindamycin, azithromycin,and
cefazolin. Endocarditis can be a very serious condition and
these patients need to be hospitalised for optimal
treatment. If not treated in time, it can result in heart
failure and death.
Can endocarditis be prevented?
Not all cases of endocarditis
can be prevented, because we don't always know when a
bacteraemia occurs. However, when patients undergo dental or
surgical procedures, antibiotics are prescribed to prevent
the bacteria from surviving in the bloodstream. It is also
important to maintain good oral health by regular visits to
the dentist.
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Endocarditis
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