Endocarditis- infective
Overview
Infective endocarditis is an infection of the lining of the heart's chambers (called the endocardium) or the heart's valves. If left untreated, endocarditis can cause other complications, such as a blood clot (embolism), an irregular heartbeat (arrhythmia), valve damage or destruction, and, in time, congestive heart failure (CHF).
Symptoms
* Heart valve inflammation * Blood clots * Fever
Causes
The infection that leads to endocarditis can be caused by bacteria, fungi, or other microorganisms that enter your bloodstream. (You may have heard the term bacterial endocarditis, subacute bacterial endocarditis, or SBE. These terms are used for endocarditis caused only by bacteria—usually group A strep—and not by other microorganisms.)
Prevention
Preventive antibiotics are often given to people at risk for infectious endocarditis before dental procedures or surgeries involving the respiratory, urinary, or intestinal tract. The American Heart Association recommends antibiotics before a dental procedure if you have: * Artificial heart valves * Certain congenital heart defects, both before or possibly after repair * History of infective endocarditis * Valve problems after a heart transplant
Diagnosis
The diagnosis of IE is straightforward in those patients with classic oslerian manifestations: bacteremia or fungemia, evidence of active valvulitis, peripheral emboli, and immunologic vascular phenomena. In other patients, however, the classic peripheral stigmata may be few or absent. This may occur during acute courses of IE, particularly among intravenous drug abuse (IVDA) patients in whom IE is often due to Staphylococcus aureus infection of right-sided heart valves, or in patients with IE caused by microorganisms such as HACEK. Acute IE evolves too quickly for the development of immunologic vascular phenomena, which are more characteristic of subacute IE. In addition, acute right-sided IE valve lesions do not create the peripheral emboli and immunologic vascular phenomena that can result from left-sided valvular involvement
Treatment
Infective endocarditis is treated with antibiotics and with surgery in some situations. Intravenous antibiotics are used for several weeks to eradicate the organism that caused the condition. But in more serious cases, urgent cardiac surgery is indicated to treat some patients. Surgery is considered particularly when a patient has an artificial heart valve. However, there is new evidence to suggest that certain kinds of bacterial infections of prosthetic valves can be treated with just antibiotics.