What is Endocarditis?
Endocarditis is an infection of the inner lining of the heart chambers and heart valves, known as the endocardium. It is commonly caused by bacteria, fungi, or other infectious agents entering the bloodstream and settling in damaged heart tissue. If left untreated, endocarditis can lead to serious complications such as heart valve damage, heart failure, and life-threatening infections.
While rare in individuals with a healthy heart, those with existing heart conditions, artificial valves, or weakened immune systems are at a higher risk. Early detection and timely treatment with antibiotics or surgery can improve outcomes and prevent complications.
Causes and Risk Factors
Endocarditis typically occurs when bacteria or fungi enter the bloodstream and attach to heart valves or damaged heart tissue. The primary risk factors include:
- Heart Valve Disease: Damaged or artificial valves provide surfaces for bacterial attachment.
- Recent Heart Surgery: Invasive procedures can introduce bacteria into the bloodstream.
- Dental Procedures: Bacteria from the mouth can enter the bloodstream during dental work.
- IV Drug Use: Unsterile needles increase the risk of bloodstream infections.
- Long-term Catheter Use: Catheters in veins provide an entry point for bacteria.
- Weakened Immune System: Conditions such as HIV or chemotherapy weaken the body's defenses.
Symptoms of Endocarditis
Symptoms of endocarditis can develop gradually or suddenly, depending on the infection's severity. Common symptoms include:
- Fever and Chills: Persistent fever is a common early symptom.
- Fatigue: Persistent tiredness due to infection.
- Shortness of Breath: Fluid buildup can affect breathing.
- Unexplained Weight Loss: Chronic infections can lead to weight loss.
- New or Worsened Heart Murmur: Infection can alter heart sounds.
- Petechiae: Small red or purple spots on the skin, mouth, or eyes due to broken blood vessels.
- Swelling in Legs or Abdomen: Heart dysfunction can cause fluid retention.
Prevention Strategies
Preventing endocarditis involves minimizing the risk of infection and protecting heart health. Key preventive measures include:
- Maintain Good Oral Hygiene: Regular brushing, flossing, and dental checkups reduce the risk of bacteria entering the bloodstream.
- Avoid Unnecessary Invasive Procedures: Limit unnecessary surgeries or catheter use to prevent infections.
- Use Sterile Equipment: Ensure sterile techniques for injections and medical devices.
- Follow Antibiotic Guidelines: High-risk individuals may require antibiotics before certain procedures.
- Manage Chronic Health Conditions: Control diabetes, immune disorders, and other underlying conditions.
Diagnosis and Treatment
Timely diagnosis and treatment are crucial to preventing complications. Common diagnostic methods include:
- Blood Cultures: Identifies bacteria or fungi in the bloodstream.
- Echocardiogram: Ultrasound imaging detects heart valve damage or vegetation.
- Electrocardiogram (ECG): Identifies irregular heart rhythms.
- CT or MRI Scans: Detects embolism-related complications.
Treatment Options
Effective treatment depends on the severity and cause of endocarditis. Common treatment approaches include:
- Antibiotic Therapy: High-dose IV antibiotics are the primary treatment for bacterial endocarditis.
- Antifungal Medications: Used for fungal infections.
- Surgery: Severe cases may require heart valve repair or replacement.
- Hospital Monitoring: Continuous observation for complications such as embolism or heart failure.