Endocarditis is also known as infective endocarditis. It is the inflammation of the endocardium (the innermost lining of the heart). Bacteria, rarely fungus and other organisms cause infective endocarditis.
Children who are born with birth defects of heart such as malformed valves or septal defects of heart are at a greater risk of developing endocarditis. In adults, it is more common in individuals with previous valve surgeries, hypertrophic cardiomyopathy, history of previous endocarditis, congenital heart defects and illegal intravenous drug abuse or long-term catheter use. All these individuals with poor oral hygiene are also at a greater risk of developing endocarditis.
Risk Factors for Developing Endocarditis
Endocarditis is less common in healthy individuals with healthy hearts. It is more common in people with heart diseases including congenital heart defects, cardiomyopathy, heart valve defects, and history of previous endocarditis, prosthetic heart valve replacement, and cardiac valvulopathy development in recipients of heart transplant, long-term use of catheters or the use of IV drugs using contaminated needles. Endocarditis may also develop due to poor dental hygiene.
Symptoms of Endocarditis
The symptoms in endocarditis include fever, chills, night sweats, fatigue, joint and muscle pain, shortness of breath, chest pain on breathing, swelling of extremities, weight loss, red spots or petechiae. On noticing these signs, one must immediately visit a doctor. Doctor may also notice heart murmur on auscultation and urine examination might also show blood. If one has a risk factor for endocarditis with heart defect or previous history of endocarditis then they should be particularly cautious about it and immediately see a medical practitioner for further evaluation.
Types of Endocarditis
Endocarditis is mostly of two types:
Acute Endocarditis: This develops suddenly in a short span of time.
Chronic Endocarditis: It is also known as Sub Acute Bacterial Endocarditis (SABE). SABE develops very slowly over a period, usually several weeks to months.
How Is Endocarditis Diagnosed?
A person should be thorough with their medical history and it is pertinent to disclose your complete medical history to your doctor. A medical practitioner will then order certain tests such as CBT (complete blood test) to look for anemia that is common in endocarditis. Endocarditis is mostly diagnosed with electrocardiogram and echocardiogram can also be done to diagnose it. Chest X-ray, MRI, or CT scan can be done to further evaluate the spread of infection to other organs.
Can You Cure Endocarditis?
Although endocarditis can be a fatal disease, but it can be cured and managed with correct diagnosis and treatment. The main goal of the treatment is to get rid of the infectious agent, whether bacteria or fungi, also to deal with the complications if they have developed. It is mostly treated with a course of antibiotic if it is caused by bacterial infection. Prompt treatment of endocarditis is needed to prevent any further complications such as a stroke or heart failure. To do this, it is necessary to administer the appropriate antibiotic, which requires proper diagnosis and identification of the infectious agent through vigilant clinical history and physical examination. Usually most of the cases are treated successfully with a course of IV/oral antibiotic over a course of 4 to 6 weeks, but in some cases surgery might be needed. Fungal endocarditis is treated with antifungals.
Apparently, 20% patients eventually might require surgery if symptoms persist with oral/IV treatment. The indications for surgery are congestive heart failure that does not respond to routine treatment, fungal infective endocarditis, persistence of sepsis even after 72 hours of antibiotic treatment, causation of conduction disturbance by septal abscess, recurrence of septic emboli immediately 2 weeks after antibiotic treatment, paravalvular abscess or valvular dehiscence.
Endocarditis has a high mortality and morbidity rate, 1 in every 5, so it is better to be cautious of the disease and prevent it as far as possible. The best way to prevent is the awareness of signs and symptoms and to visit doctor immediately. Endocarditis is known to recur in patients with a history of endocarditis, so they should be extra vigilant and visit doctor regularly.
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