Endocarditis

Overview

Endocarditis is a life-threatening inflammation of the inner lining of the heart's chambers and valves, known as the endocardium. This condition is usually caused by an infection from bacteria, fungi, or other germs that enter the bloodstream and attach to damaged areas in the heart. Risk factors for endocarditis include artificial heart valves, damaged heart valves, or other heart defects. If left untreated, endocarditis can damage or destroy heart valves and lead to serious complications, such as heart failure, stroke, blood clots, kidney damage, and an enlarged spleen. Symptoms of endocarditis may include aching joints and muscles, chest pain, fatigue, flu-like symptoms, night sweats, shortness of breath, and swelling in the feet, legs, or belly. If you experience these symptoms, it is crucial to see a healthcare provider promptly, especially if you have a congenital heart defect or a history of endocarditis.

Understanding the disease

Symptoms

The symptoms of endocarditis may include aching joints and muscles, chest pain when breathing, fatigue, flu-like symptoms such as fever and chills, night sweats, shortness of breath, swelling in the feet, legs, or belly, a new or changed whooshing sound in the heart (murmur), unexplained weight loss, blood in the urine, tenderness under the left rib cage (spleen), painless red, purple, or brown flat spots on the soles, bottom of the feet, or the palms of the hands (Janeway lesions), painful red or purple bumps or patches of darkened skin (hyperpigmented) on the tips of the fingers or toes (Osler nodes), and tiny purple, red, or brown round spots on the skin (petechiae), in the whites of the eyes, or inside the mouth. If you have any of these symptoms, it is important to see a healthcare provider as soon as possible.

Risk Factors

Risk factors for endocarditis include older age (most common in adults over 60), artificial heart valves, damaged heart valves or other heart defects, a history of endocarditis, congenital heart defects, and having an implanted heart device. Other factors that can increase the risk of endocarditis include certain medical conditions such as rheumatic fever or infection, as well as illegal use of intravenous drugs and the use of dirty needles. It's important to inform your healthcare providers if you are at risk of endocarditis.

Development

Endocarditis typically develops as a result of an infection caused by bacteria, fungi, or other germs that enter the bloodstream and attach to damaged areas in the heart, such as damaged heart valves or other heart defects. The infection can develop slowly or suddenly, depending on the type of germs causing it and whether there are other heart problems. In the case of artificial heart valves or damaged heart tissue, the germs can more easily attach and cause infection. In some cases, the body's immune system may not be able to destroy the harmful bacteria, allowing the infection to progress. Risk factors for endocarditis include older age, artificial heart valves, damaged heart valves, certain medical conditions, and illegal intravenous drug use. Endocarditis can lead to complications such as heart failure, heart valve damage, stroke, and blood clots. Prevention measures include maintaining good oral hygiene, avoiding illegal intravenous drug use, and ensuring proper care and maintenance of implanted heart devices.

Assessment and Diagnosis

Triage

You should see a doctor if endocarditis is suspected, especially if you have a congenital heart defect or a history of endocarditis. Symptoms that may indicate a worsening infection include chills, fever, headaches, joint pain, and shortness of breath.

Diagnosis

To diagnose endocarditis, a healthcare provider will typically start with a physical exam and gather information about your medical history and symptoms. Tests are then performed to confirm or rule out endocarditis. These tests may include a blood culture test, complete blood count, electrocardiogram (ECG or EKG), chest X-ray, and computerized tomography (CT) scan or magnetic resonance imaging (MRI). A blood culture test helps identify germs in the bloodstream, while a complete blood count can determine if there are many white blood cells, which can be a sign of infection. An electrocardiogram measures the electrical activity of the heart, and chest X-ray can show any heart swelling or infection spreading to the lungs. Scans may also be performed if the provider suspects infection has spread to other areas of the body.

Management and Treatment

Complications

Potential complications of endocarditis include heart failure, heart valve damage, stroke, pockets of collected pus (abscesses) in the heart, brain, lungs, and other organs, blood clot in a lung artery (pulmonary embolism), kidney damage, and an enlarged spleen. Early diagnosis and treatment of endocarditis can help reduce the risk of these complications. It's essential to recognize the signs and symptoms of endocarditis, such as fever, unexplained fatigue, skin infections, and persistent open cuts or sores, and seek medical attention promptly.

Prevention

Some measures can be taken to help prevent endocarditis. These include:

1. Knowing the signs and symptoms of endocarditis: Be aware of the symptoms, such as fever, unexplained fatigue, skin infections, and unhealing wounds. Seek medical attention promptly if any symptoms occur.
2. Maintaining good dental hygiene: Brush and floss your teeth regularly, and schedule regular dental checkups to maintain overall health.
3. Avoiding illegal drugs: Refrain from using dirty needles, as they can introduce bacteria into the bloodstream and increase the risk of endocarditis.
4. Telling your healthcare providers about your risk of endocarditis: Inform your healthcare providers if you have a higher risk of endocarditis due to artificial heart valves, damaged heart valves, or other heart defects. Consider requesting an endocarditis wallet card from the American Heart Association. While these measures may help reduce the risk of endocarditis, it's important to remember that endocarditis can still occur even with preventative measures in place. Prompt medical attention and treatment are crucial for managing the condition effectively.

Home Remedies

It is important to seek medical attention and follow the recommendations of healthcare professionals for the treatment and management of endocarditis.

Treatment

Treatments for endocarditis include medications and surgery. Medications may consist of antibiotics to fight the infection, as well as medications to manage symptoms and prevent blood clots. Surgery may be required to repair or replace damaged heart valves, or to remove abscesses and vegetations. Prevention measures include knowing the signs and symptoms of endocarditis, taking care of your teeth and gums, and avoiding illegal drug use.

Preparing for medical consultation

To prepare for an appointment for endocarditis, you can follow these steps:

1. Write down any symptoms you're experiencing, including their duration and if they have occurred in the past.
2. Make a list of your