Endocarditis is a lethal swelling of the inner layer of the heart chambers and valves. The inner layer of the heart is called the endocardium. It is usually caused by bacteria, fungi, and other lethal infections and germs in the blood attached to the heart. Damaged heart valves, heart defects, or artificial heart valves also cause endocarditis. Endocarditis is usually cured by regular medications or surgery. Without medication, endocarditis should be lethal.

Symptoms of Endocarditis:

There are many symptoms of endocarditis which can vary from person to person. In some cases, it develops suddenly or gradually, which depends on the type of bacteria and fungi that causes infection in the heart lining. The common symptoms of endocarditis are as follows:

  • Trouble in breathing
  • Chest pain
  • Soreness in joints and muscles
  • Fatigue 
  • Fever, symptoms of flu 
  • Sweating at night 
  • Swelling of legs, feet
  • Murmuring of heart
  • Rashes on the skin
  • Loss of appetite
  • Blood clotting
  • Strokes
  • Vomiting, diarrhea
  • Brain hemorrhages
  • Headaches
  • Severe cough 
  • Wounds in the body

Less common symptoms are as follows:

  • Weight loss
  • Urine with blood
  • The left rib cage becomes soft
  • Redness in the soles or bottom of feet and hands with severe pain
  • Hyperpigmentation of skin
  • Painful red and blue patches of skin
  • Whiteness of eyes and mouth with red and brown spots.

Causes:

It is usually caused by bacteria, fungi, and other germs. These germs enter the body, move towards the heart, attach to the heart’s inner lining, and damage the heart valves and tissues. Usually, the immune system kills harmful germs, but the bacteria on the skin, mouth, gut, or throat enter the blood and cause severe endocarditis. Sometimes dental procedures aid the germs from entering the bloodstream. The germs may also enter the bloodstream through:

  • Eating
  • Brushing teeth
  • Dental flossing

The germs immediately form colonies and enzymes to destroy heart tissues. Artificial heart valves have more chances of infection than original heart valves because they are much more resistant to disease.

Risks of endocarditis:

A damaged inner lining of the heart is at high risk of endocarditis. The dangers of endocarditis are as follows:

  • Aged person: Endocarditis mainly occurs in adults, such as at the age of 60 or above.
  • Faulty inner lining of the heart: Diseases like rheumatic fever can destroy the heart’s inner lining and increase the risk of infection.
  • Artificial heart lining: Germs have more chances of causing infection in the artificial heart lining and lead to severe endocarditis.
  • Heart disorders: The risk of endocarditis increases in children born with defective or irregular heart valves.
  • Insertion of heart devices: Germ and bacteria are attached to devices inserted in the heart that increase the risk of endocarditis.
  • Illegal drug usage: Using infected and contaminated syringes increases the risk of endocarditis. People who intake illegal IV drugs are more likely to get the infection through syringes and needles.
  • Dental problem: Through dental procedures, bacteria may enter the mouth or the bloodstream that cause infection.

Complications:

Following are the complications of endocarditis:

  • Failure of the heart 
  • Damaged heart valve
  • Strokes
  • Pus in the heart, lungs, brain, and other body organs
  • Kidney disorder
  • Spleen enlargement
  • Blood clotting in the lungs

Preventions of endocarditis:

The preventions of endocarditis are as follows:

  • If any symptom develops in your body, especially fever, cold, fatigue, or skin allergy, immediately consult your doctor or health guide.
  • Keep special care of wounds as the risk of endocarditis increases if wounds don’t heal properly.
  • Brush your teeth after every meal and take extra care of your gums. Maintain your overall health through good dental hygiene and regular dental checkup.
  • Avoid using illegal IV drugs because their dirty syringes contain bacteria that enter the body, travel into your bloodstream, and cause endocarditis.

Diagnosis:

Your doctor may ask about your medical history or symptoms to diagnose endocarditis. Moreover, following different tests are done to confirm whether you have endocarditis or not. 

  • Cultured blood Test: This test identifies the presence of bacteria and other germs in your body. It is also used to determine which antibiotic benefits the patient.
  • Complete blood count: This test determines the body’s level of white and red blood cells. A low level of red blood cells and a high level of white blood cells are signs of endocarditis.
  • Electrocardiogram: It is a painless test used to determine the heart’s activity. This test involves electrodes connected to the chest, arms, or legs. 
  • Echocardiogram:  In this test, sound waves are used to develop images of the heartbeat and identify how well the heart pumps the blood. 
  • X-ray of the chest: It is used to determine the state of the heart or lungs, such as heart swelling or any other lung infection caused by endocarditis.
  • CT scan or MRI scan: If the infection spreads, the doctor will suggest a CT scan or MRI test of your brain, chest, or other body parts.

Treatments:

Antibiotics are used to treat endocarditis. In some cases, surgery is suggested by doctors to cure faulty heart valves and infections caused by endocarditis.

  • Medications: The dosage of the medicine depends on the type of endocarditis. If the bacteria cause endocarditis, a high dose of IV antibiotic is given to the patient to treat damaged heart valves. Doctors suggest that endocarditis patients stay at least one week at the hospital and afterward take antibiotics at home for several weeks. Likewise, antifungal medicine is given to the patient if fungi cause it. 
  • Surgery: In some cases, heart valve surgery is suggested by the doctor to treat infection of endocarditis or replace the faulty valve. Sometimes, endocarditis caused by fungi is also treated with surgery. 

How often is endocarditis?

Persons with healthy hearts hardly have endocarditis. In the United States, 47,000 people are diagnosed with endocarditis every year. Endocarditis affects following people who have

  • Rheumatic heart disorder
  • Congenital heart disorder
  • Disturbed immune system
  • Drug habit
  • Heart issues from birth 

 

References:

  • https://www.mayoclinic.org/diseases-conditions/endocarditis/symptoms-causes/syc-20352576#:~:text=Endocarditis%20is%20a%20life%2Dthreatening,damaged%20areas%20in%20the%20heart.
  • https://my.clevelandclinic.org/health/diseases/16957-endocarditis
  • https://www.nhs.uk/conditions/endocarditis/
  • https://www.webmd.com/heart-disease/what-is-endocarditis