Endocarditis

What is Endocarditis?

Endocarditis occurs when the interior lining of the heart (endocardium) becomes infected. It can cause major heart valve damage, organ damage, abscesses in vital organs, stroke and heart failure. It is triggered by bacteria, fungi or a virus that travels via the bloodstream.

The risk for men of all ages is double that of women. Approximately 25% of those afflicted are over 60 years of age, and mature males are eight times more likely to develop endocarditis than women in the same age group.

Most commonly, the infection is caused by the presence of staphylococcus aureus , a bacterium that can enter the body through a number of routes including surgical dental work, open sores, diseased intestines, infected needles, body piercings and catheters.

The bacteria usually latch onto artificial heart valves or those that are already damaged, but on rare occasions can attack an otherwise healthy heart.

What are the Symptoms of Endocarditis?

The rate at which endocarditis symptoms appear depends on the origin of the infection and can vary from one person to the next.

Symptoms include

  • Chills
  • Joint and muscle pain
  • Fever
  • Newly diagnosed or worsening heart murmur
  • Pale complexion
  • Breathing difficulties
  • Night sweats
  • Nagging cough
  • Water retention in the abdomen, feet or legs
  • Unexpected weight loss
  • Visible or unapparent blood in the urine
  • Pain on the left side just beneath the rib cage (spleen)
  • Sore red spots on the fingers (Osler’s nodes)
  • Little purple or red dots (Petechiae) on the white parts of the eyes, the skin and/or in the mouth

Endocarditis Causes

Endocarditis is caused when the endocardium, which is the inner lining of heart valves and chambers, becomes infected by bacteria, fungi, or other organisms in the bloodstream. Although a higher risk of developing this condition is typically assigned to those with congenital heart defects, damaged heart valves, and artificial heart valves, endocarditis can also develop in otherwise healthy patients.

Causes include:

  • Germs entering the bloodstream through bleeding gums that result from daily oral care, such as brushing and flossing
  • Dental procedures that cause bleeding, which allows germs to enter the bloodstream
  • Respiratory tract procedures, such as tonsillectomy
  • Infections, including open sores and sexually transmitted infections
  • Diseases, such as gum diseases or inflammatory bowel disease
  • Medical conditions, including intestinal disorders
  • Catheters, particularly if a catheter has been inserted for a long time
  • Contaminated needles that are used for illegal intravenous (IV) drug use, piercing, and tattooing
  • Gastrointestinal procedures, such as esophageal stricture dilation
  • Genitourinary tract procedures, including prostatic surgery, cystoscopy, and urethral dilation.

How is Endocarditis Treated?

The first step in the treatment of endocarditis is an aggressive course of intravenous antibiotic medications from 14 to 42 days or more. If the heart valve(s) were damaged, surgical repair or replacement may be necessary. Complications and symptoms can continue for many years. The infection is always fatal when left untreated.

Endocarditis Prevention

Those who are higher-risk candidates for developing endocarditis should carefully heed the preventive measures that may lower the risk of infection. Observe proper dental hygiene, including routine brushing and flossing, and follow a schedule of regular dental visits. Prevent skin infections by treating sores according to a doctor’s recommendation; for example, using antibiotic cream. Keep the skin clean by properly bathing and thoroughly washing hands. Immediately wash and clean all cuts to prevent infection. Take oral antibiotics as prescribed by a physician to treat illness or infection. Consult with a dentist to determine if antibiotic prophylaxis is recommended before dental procedures. Consult with a doctor to determine if antibiotic prophylaxis is recommended before surgeries or other medical procedures. Practice abstinence or wear condoms before engaging in sexual behavior that may transmit disease. Observe proper catheter insertion and care. Avoid unnecessary cosmetic procedures that break the skin, such as piercing and tattooing.