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By Dr Prashant Sadashiv Shinde
Consultant Interventional Cardiologist
Overview Symptoms When to see a doctor? Causes Diagnosis Treatment Care at Medicover

Endocarditis

Endocarditis is an inflammation of the endocardium, of the inner layer of the heart or the heart valves. This condition typically occurs due to fungus, bacteria, or other germs passing through the bloodstream from different parts of your body, including the mouth, and attaching themselves to the heart. If it is not treated immediately, it might harm the heart valves and result in life-threatening problems.

Antibiotic medications can treat this condition, but sometimes surgery may be required. Your doctor might be unable to identify the exact cause of endocarditis as it is caused by many different health reasons. However, those with mechanical heart valves, damaged heart valves, repaired mitral valves, or other cardiac conditions are more likely to develop endocarditis. Endocarditis can damage the heart valves if it isn't treated immediately.

Symptoms

Endocarditis symptoms can differ from one person to another. Here are some of the common symptoms of endocarditis:

When to see a doctor?

Consult your healthcare provider as soon as possible if you experience endocarditis symptoms, especially if you have a congenital heart defect or a history of endocarditis. Some other conditions may have similar symptoms. A proper evaluation by a healthcare provider is needed to make the diagnosis. Tell your doctor if you've been diagnosed with endocarditis and have the following symptoms. These symptoms may occur if the infection gets worse:

Causes

The leading cause of endocarditis is prexisting heart problem like valvular or congenital heart disease with overgrowth of bacteria. Although these bacteria often live inside or outside your body, eating or drinking might transfer them to your bloodstream. Also, injuries on your skin or mouth might allow bacteria to enter into the blood. The immune system often eliminates bacteria before they cause any issue, but in some people, it proves unsuccessful.

When you have infective endocarditis, bacteria enter your bloodstream and then go to your heart, where they grow and inflame the heart tissues. Other bacteria or fungi may also cause endocarditis. Eating and drinking aren't the only ways germs can enter your body. You can also expose yourself to them by:

  • Having poor oral hygiene or gum disease
  • Having a dental procedure that cuts your gums
  • Contracting a sexually transmitted disease
  • Using a contaminated needle
  • Through an indwelling urinary catheter or intravenous catheter

Risk factors

A person may be more susceptible to getting endocarditis if they:

As people age, their heart valves degenerate, increasing the risk of endocarditis.

Complications

The heart develops a mass from irregular bacterial and cell fragment growth in endocarditis. These groups are referred to as vegetation. They can get dislodged and reach many organs, including the kidneys, lungs, and brain. They can also reach the arms and legs. Complications of endocarditis may include:

Prevention

Reduce your exposure to any infection that can induce endocarditis if you are at a higher risk of contracting it. The precautions taken to lower the risk of endocarditis are listed below:

  • Practice good oral hygiene to prevent bacterial growth in the mouth.
  • Avoid using illegal drugs, especially injectable drugs, which can increase the risk of endocarditis.
  • If you have a heart condition, follow your doctor's instructions for preventing endocarditis.
  • Get regular dental checkups and cleanings, as oral unhygiene can increase the risk of endocarditis.
  • If you have a heart valve disorder, your healthcare provider may recommend taking antibiotics before specific medical or dental procedures.
  • Avoid smoking and limit alcohol consumption.
  • Keep your blood sugar levels under control if you have diabetes.
  • Keep the blood pressure under control if you have hypertension.
  • Exercise regularly to improve cardiovascular health
  • If you have endocarditis, follow your healthcare provider's instructions for treatment and follow-up care to prevent complications.

Diagnosis

The doctor will review your symptoms and health history before ordering any tests. These tests may then be performed after that:

Blood culture test

This examination checks for germs or fungus in your bloodstream.

Complete blood count

This test may identify many white blood cells, indicating an infection. Low levels of healthy red blood cells can be detected with a complete blood count, which can signify endocarditis. Other blood tests also may be done.

Echocardiogram

Echocardiogram : It might reveal abscesses, growths, new regurgitation or stenosis, or an artificial heart valve that has started to separate from your heart tissues.

Positron emission tomography (PET) or nuclear medicine

scans create images using radioactive material that can show an infection's location.

Electrocardiogram (ECG)

Electrocardiogram (ECG) : Endocarditis is not usually diagnosed with this test. An ECG can show the doctor if something is interfering with your heart's electrical activity. Sensors are attached to your arms, legs, and chest while an ECG has been taken.

Chest X-Ray

Chest X-Ray : Your doctor can evaluate the condition of your heart and lungs by using the pictures generated by the chest X-ray. Using these images, your doctor can also determine whether endocarditis has resulted in any heart enlargement or if there are any signs of infection.

MRI or CT scan

MRI or CT scan : Your doctor could recommend getting a chest MRI or brain CT scan, depending on the severity of your disease. Your doctor can use this information to determine if the infection has affected these areas.

Treatment

Medications

Medication depends on what's causing the endocarditis. Bacterial endocarditis is treated with doses of IV antibiotics. If you take IV antibiotics, you will often stay in the hospital for a week or more so that medical professionals can assess how well the therapy works. You could be allowed to leave the hospital if your fever and any other severe symptoms have subsided.

Some patients continue IV antibiotics while receiving treatment at home or in the doctor's office. Antifungal medicine is administered if a fungal infection results in endocarditis. Some patients require lifetime antifungal medication to guard against recurrent endocarditis.

Surgery

Surgery may be necessary to treat chronic infective endocarditis or heart valve damage brought on by endocarditis. Any dead tissue, scar tissue, fluid collection, or debris from diseased tissue may be removed surgically. The damaged heart valve may also be removed during surgery and replaced.

Do’s and Don’ts

The Do's and Don'ts mentioned below can help prevent the negative consequences of endocarditis.

Do’sDon’ts
Visit your doctor if you have any symptoms of endocarditis, such as fever, chills, fatigue, etc.Smoke or use tobacco products.
Follow your doctor's instructions for taking antibiotics if prescribed.Stop taking antibiotics or other medications without your doctor's approval.
Maintain good oral hygiene to prevent dental infections, which can lead to endocarditis.Share your items, such as toothbrushes or razors.
Take steps to prevent infection by washing your hands frequently.Ignore follow-up appointments with your doctor.
Manage underlying medical conditions, such as diabetes and high BP, that can increase your risk of endocarditis.Engage in activities that can cause injury to your heart valves, such as contact sports.

Endocarditis Care at Medicover

Endocarditis treatment is performed at Medicover by the best Cardiologists and medical professionals. Our highly qualified staff treats a variety of Heart conditions using the most up-to-date diagnostic tools, medical equipment, and technologies. We use a multidisciplinary approach to treat Endocarditis by providing the patients with complete care and monitoring their health and medical requirements for a faster and more sustainable recovery.

Citations

https://www.nhs.uk/conditions/endocarditis/
https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-problems-and-causes/heart-valves-and-infective-endocarditis
https://www.bhf.org.uk/informationsupport/conditions/endocarditis
https://www.sciencedirect.com/topics/medicine-and-dentistry/endocarditis
https://www.healthdirect.gov.au/endocarditis
https://www.rwjbh.org/treatment-care/heart-and-vascular-care/diseases-conditions/endocarditis/
https://www.osmosis.org/learn/Endocarditis
https://www.rcemlearning.co.uk/reference/endocarditis/

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Frequently Asked Questions

1. Can the Endocarditis be cured?

Many children with Endocarditis may need surgery to correct their heart issues, generally performed before the child reaches age 1. Endocarditis can cause complications if the heart is not corrected; however, corrective surgery for Endocarditis performed in childhood does not cure the issue.

2. Can babies live with Endocarditis?

Most children with a Endocarditis surgical repair can live a healthy life.

3. Does TOF affect the brain?

Even when intracardiac abnormalities are addressed in children with Endocarditis (TOF), there is a risk of brain harm.

4. Can TOF cause heart failure?

Because of an increased prevalence of heart failure, heart disease is more common in TOF men aged 20 to 59 years old than in age-matched men in the general population. The majority of heart failure found in TOF patients (of all ages) is caused, at least in part, by pulmonic insufficiency.

5. What will happen if the Endocarditis is left untreated?

If TOF is not treated, it can lead to irregular heartbeats, developmental delays, and seizures. If the condition is not treated, which is rare, it usually leads to fatality before age 20. Usually, a doctor will detect the disease early on and perform surgery to repair it.

6. How do you take care of a child with Endocarditis?

Babies with Endocarditis may become tired when nursing or feeding. Shorter, more frequent meals may be easier for the infant to swallow. The child may also require additional nutrients, and a supplement or an additional feeding can provide the infant with additional calories, vitamins, or iron.