Endocarditis or infective endocarditis is the inflammation of the endocardium (the inner lining of the heart). Endocarditis is mostly bacterial in etiology, but can be caused by fungi and other micro organisms too.
Endocarditis usually does not present in healthy individuals. It is more common in individuals with previous heart disease such as congenital heart defects, heart valve defects, hypertrophic cardiomyopathy, and prosthetic replacement of the heart valve, history of previous endocarditis, long term use of IV drugs and also IV catheters, recent history of invasive procedures such as wound care or hemodialysis. A form of infective endocarditis, known as SABE (sub-acute bacterial endocarditis) might also develop in people with poor dental hygiene that might lead to bacteremia and ultimately endocarditis.
Signs and Symptoms of Endocarditis
To know whether one is cured of endocarditis or not, first and foremost, it is imperative to understand the signs and symptoms it presents with.
Infective endocarditis is a life threatening disease that is associated with high morbidity and high mortality rate. Endocarditis presents with symptoms such as fever and chills, night sweats, fatigue, joint pain and muscle pain, shortness of breath, chest pain on breathing, swelling in feet, bilateral legs or abdomen along with heart murmur (abnormal/new heart sound heard by physician on clinical examination). Endocarditis can also present with some uncommon symptoms such as unexplained weight loss, blood in urine (hematuria); which might be visible through naked eyes or through urinalysis, tenderness in spleen, red spots on the soles of feet or the palms of hands, red tender spots under the skin of fingers and toes or petechiae (tiny purple or red spots on skin, eyes or inside the mouth).
These are the signs to look for in endocarditis and when one notices them it is best to visit a doctor for treatment. The doctor will look for signs of endocarditis and if diagnosed positive then he/she will treat it either with antibiotics and/or surgery depending on the case. Also certain procedures such as some dental procedures require prophylactic antibiotics to prevent endocarditis.
How will I Know If Endocarditis is Gone?
The signs and symptoms of endocarditis will start subsiding with appropriate treatment whether it is antibiotic treatment and/or required surgery. The patients with endocarditis may also be on anticoagulation therapy and on evaluating all the risks factors; the physician might discontinue the anticoagulation therapy for a couple of weeks in certain cases. Also patients need to be under antibiotic prophylaxis for certain dental procedures to prevent recurrence of endocarditis in high risk patients.
Most of the cases of infective endocarditis subside with appropriate treatment and the patient will notice resolution of his symptoms, but one should be wary of the complications of endocarditis.
The main complication of infective endocarditis after surgery is recurrence of endocarditis along with heart failure, need for valve surgery and death. To maintain stable heart health a patient should be punctual with regular follow-ups with his cardiac specialist whether it is short term follow up or long term follow up. Short term follow up includes transthoracic echocardiography, cardiac rehabilitation, patient education on endocarditis, dental evaluation, removal of IV catheter upon completion of antibiotic therapy, blood culture, physical examination to rule out any congestive heart failure. The long term follow up includes echocardiography to evaluate heart health, continued dental evaluation, patient education on recurrence.
Conclusion
Infective endocarditis is a fatal disease with high risk of complications and mortality with heart failure if not taken proper care of. The patient has to cope with endocarditis diagnosis and treatment, so it is advisable to be vigilant for signs and symptoms of it and to report to your physician at the first sign of symptoms. It is imperative to not ignore the symptoms until it is too late and life threatening and there is no coming back. However, it is preventable and treatable if detected early, but regular follow up of the patient is required and lifelong care is needed to prevent recurrence of this life threatening disease.
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