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Endocarditis - Symptoms, Causes and Treatment

Definition

Endocarditis is an uncommon but not rare disease it is a infection of bacteria. It is affecting about 10,000 - 20,000 persons in the United States each year. This bacterial endocarditis is affected of the heart's inner lining (endocardium) or the heart valves. This can damage your heart valves. Endocarditis usually occurs in patients with congenital (i.e., present at birth) or acquired heart conditions (e.g., atrial septal defects, valve disease). It may also occur in someone who has had no previous problem with their heart, and who has not had any other procedure which is associated with a risk of endocarditis.
Endocarditis is rare in people with healthy hearts. People at greatest risk of endocarditis have a damaged heart valve, an artificial heart valve or other heart defects.

Causes

This may present in two ways: Acute Bacterial Endocarditis, mainly caused by staphylococci, or streptococci, or pneumococci or gonococci. The Subacute (SBE) illness mostly caused by other streptococci or haemophilus bacteria. In 5 to 10% of cases fungal infection or some rare bacteria may be the cause of endocarditis and in this group the blood cultures are negative.
The following heart conditions increase the risk :-

Atrial septal defect (i.e., hole in the wall between the upper chambers of the heart)
Prior endocarditis
Prosthetic heart valve
Surgical shunt from aorta to pulmonary artery
Ventricle defect
Injection drug use, recent dental surgery, permanent central venous accesses lines, prior valve surgery, and weakened valves are also the risk factors for developing endocarditis.

Symptoms

It is normal for bacteria in the mouth, intestinal tract or urinary tract to travel to the heart via the bloodstream and this usually does not cause a problem. However, hearts that have defects, often even if the defects have been repaired are vulnerable to infection. Symptoms of bacterial endocarditis may include :-

Fever
Fatigue
loss of appetite,
night sweats
chills
headaches
joint discomfort
tiny pinpoint-sized hemorrhages on the chest and back, fingers, or toes.

Upon examination, the physician may also detect a new heart murmur and small hemorrhages in the mucous membranes of the eyes.
The combination of certain symptoms with particular findings on physical examination will prompt the treating physician to consider endocarditis as the source of the problem.

Treatment

Treatment of endocarditis requires antimicrobial therapy, sometimes for two, but often for 4-6 weeks. In some, surgery is required to remove the infection from the heart, to correct pre-existing heart disease, or to repair the heart or valve damage caused by the infection. The common reasons for cardiac surgery during endocarditis include :-

Heart failure
Uncontrolled infection
Significant valve dysfunction
Artificial valve infection
Extension of the infection into the heart (abscess formation)
Recurrent emboli

If heart failure occurs, your child may need surgery to repair or replace the affected heart valve. If the diagnosis is delayed and severe heart damage has occurred, the child may die.