Endocarditis is an infection of the inner lining of the heart and its valves. The infection is caused by bacteria or fungi that enter the bloodstream through the mucous membranes of the mouth, open wounds, needles. This condition can also happen from medical procedures which involve cutting through infected skin.
Endocarditis can lead to other life-threatening conditions. Stroke or reduced blood flow to other organs can occur when clumps of bacteria break off from the heart and block the blood vessels.
The bacteria that cause endocarditis can also spread to other organs, causing additional tissue damage. Uncontrolled endocarditis can permanently damage the heart valves, eventually leading to heart failure.
Causes of Endocarditis
Endocarditis is caused by bacteria or fungi that enter the bloodstream from outside the body. Endocarditis is unusual in people with healthy hearts. Some of the heart diseases or disorders, and procedures used to treat certain types of heart disease, make people more susceptible to endocarditis, including:
- Congenital heart disease
- Valve disease
- Hypertrophic cardiomyopathy
- Implantation of an artificial heart valve
- Implanted devices, such as a pacemaker
Patients who had endocarditis once are more susceptible to another heart infection. People who use intravenous drugs and those who have a compromised immune system (for example, from HIV or from an organ transplant) are also more likely to develop a heart infection.
Diagnosis of Endocarditis
Tests commonly used to diagnose endocarditis include:
- Blood Tests
- Chest X-rays, Computed Tomography and Magnetic Resonance Imaging (MRI)
Risk factors & preventions
Patients who are having high risk of endocarditis should practice good dental hygiene, including regular brushing, flossing and visits to the dentist. The bacteria that cause endocarditis often enter the bloodstream though tissue damage in the mouth caused by poor dental hygiene (gingivitis).
Patients who are having high risk of endocarditis should also avoid cosmetic procedures, such as piercing or tattooing, which can push bacteria from the skin into the bloodstream. Patients at high risk should also see a doctor if they have normal wounds that do not heal quickly.
Finally, patients who are having high risk of endocarditis may be prescribed preventive antibiotics before some medical procedures, including dental work that involves cutting into the gums or teeth, or certain types of surgery.
Symptoms of Endocarditis
The most common symptoms of endocarditis mimic the flu or other viral infections, including:
- Sweating, night sweats
- Lack of energy, weakness
- Aching joints and muscles
Treatment of Endocarditis
Very high doses of antibiotics or antifungal drugs are used to treat the heart infection. They are delivered directly into a vein though an intravenous (IV). The drugs are usually given continuously for about six weeks. Drug treatment for endocarditis begins in the hospital, but some patients can complete their IV treatment at home.
Sometimes surgery is needed to remove damaged tissue or areas of infection. Fungal infections are harder than bacterial infections to treat with drugs alone.
Surgery may also be needed to repair or replace a heart valve damaged by endocarditis.