Definition, Symptoms, and Complications of Endocarditis
- Endocarditis is an infection of the inner lining of the heart chambers and heart valves.
- It is typically caused by bacteria entering the bloodstream and attaching to damaged heart tissue.
- Common symptoms include fever, fatigue, heart murmur, joint pain, night sweats, weight loss, and small reddish spots on the skin.
- If left untreated, endocarditis can lead to serious complications such as valvular insufficiency, heart failure, stroke, and kidney failure.
Risk Factors and Diagnosis of Endocarditis
- People with certain heart conditions, such as congenital heart defects or artificial heart valves, are at higher risk.
- Intravenous drug users who inject drugs into their veins are also at increased risk.
- Dental procedures, poor dental hygiene, and skin infections can introduce bacteria into the bloodstream and increase the risk of endocarditis.
- Diagnosis is based on a combination of clinical symptoms, medical history, and laboratory tests including blood cultures and echocardiography.
- The Duke criteria are widely used to help diagnose endocarditis based on specific clinical criteria.
Treatment of Endocarditis
- Treatment usually involves a combination of antibiotics to target the specific bacteria causing the infection.
- The choice of antibiotics depends on the type of bacteria and their susceptibility to certain drugs.
- In severe cases, hospitalization may be required for intravenous antibiotic therapy.
- Surgery may be necessary to repair or replace damaged heart valves or to drain abscesses.
- Long-term antibiotic prophylaxis may be recommended for individuals at high risk of recurrent endocarditis.
Prevention of Endocarditis
- Maintaining good oral hygiene, including regular dental check-ups, can help prevent oral infections that may lead to endocarditis.
- Individuals at high risk, such as those with artificial heart valves, may be prescribed antibiotics before certain dental or medical procedures.
- Avoiding intravenous drug use and practicing safe injection techniques can reduce the risk of bloodstream infections.
- Education and awareness campaigns can help promote understanding of the risk factors and symptoms of endocarditis.
- Early diagnosis and treatment of infections, particularly in individuals with heart conditions, can help prevent the development of endocarditis.
Populations at Risk and Statistics
- Populations at high risk include those with previous infective endocarditis, surgical or transcatheter prosthetic valves, untreated congenital heart disease, and surgically corrected congenital heart disease.
- The number of people affected is about 5 per 100,000 per year.
- Rates of endocarditis vary between regions of the world.
- Males are affected more often than females.
- The risk of death among those infected is about 25%, and without treatment, it is almost universally fatal.
Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves. Other structures that may be involved include the interventricular septum, the chordae tendineae, the mural endocardium, or the surfaces of intracardiac devices. Endocarditis is characterized by lesions, known as vegetations, which is a mass of platelets, fibrin, microcolonies of microorganisms, and scant inflammatory cells. In the subacute form of infective endocarditis, the vegetation may also include a center of granulomatous tissue, which may fibrose or calcify.
Endocarditis | |
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Bartonella henselae bacilli in cardiac valve of a patient with blood culture-negative endocarditis. The bacilli appear as black granulations. | |
Specialty | Cardiology, Infectious disease |
There are several ways to classify endocarditis. The simplest classification is based on cause: either infective or non-infective, depending on whether a microorganism is the source of the inflammation or not. Regardless, the diagnosis of endocarditis is based on clinical features, investigations such as an echocardiogram, and blood cultures demonstrating the presence of endocarditis-causing microorganisms.
Signs and symptoms include fever, chills, sweating, malaise, weakness, anorexia, weight loss, splenomegaly, flu-like feeling, cardiac murmur, heart failure, petechia (red spots on the skin), Osler's nodes (subcutaneous nodules found on hands and feet), Janeway lesions (nodular lesions on palms and soles), and Roth's spots (retinal hemorrhages).
endo- + carditis
endocarditis (countable and uncountable, plural endocarditides or endocarditises)