Ignoring infective endocarditis can lead to heart failure, central nervous system failure, and even death. Includes membranes lining the heart chambers, valves, large blood vessels in the chest, foreign bodies in the heart (if present) such as pacemaker electrodes. They are caused by strong bacteria, with which the weakened immune system fights an uneven fight.
The risk includes damage to the structures of the heart (in particular the valves) and peripheral emboli, which are conducive to the formation of infarctions, inflammation of internal organs and abscesses. Microabscesses, i.e. irregular eminences formed on the valves, result in perforations and ulcerations.
I stage of the disease
The first symptoms infective endocarditis are relatively innocent, there is sweating, increased body temperature, lack of appetite and general weakness combined with headaches, muscle and joint pain that accompany an average infection. However, at the same time, back pain may occur, as well as pain in the chest or abdomen.
II stage of the disease
At this stage, the symptoms are much more pronounced, depending on whether the right or left side of the heart is affected. In both cases, murmurs are revealed during auscultation, but their nature indicates the location of the lesions. Symptoms become apparent within a few days of infection.
When the inflammation affects the right atrium, the ventricle and the pulmonary trunk connected to it, chills and night sweats are characteristic, possibly shortness of breath, cough suggestive of pneumonia. Sometimes there is chest pain.
The affected left side of the heart is associated with embolism (disorders of peripheral circulation): painful clusters on the fingers and toes – the so-called Osler’s nodules, petechiae located under the nail plate resembling a splinter, skin petechiae. Sometimes there are symptoms of left ventricular failure, usually easy fatigability and shortness of breath
Sepsa
Let’s bear in mind that endocarditis is associated with infection of the blood, is sepsis, so microbes are able to spread throughout the body. Starting with the heart, if left unchecked, they will attack other organs relatively quickly, leading to their failure and, consequently, to the death of the patient. The cause is usually bacteria, streptococci, staphylococci, rarely fungi. Infection occurs as a result of breaking the continuity of the mucous membranes, e.g. during dental procedures.
People with heart defects, heart disease, mitral valve prolapse and regurgitation, and people with prosthetic heart valves are at increased risk. Low immunity, old age, cancer, leukemia, intravenous drug use also make the body more susceptible to infection.
Diagnosis and rescue
Blood culture will allow the detection of bacteria in the body, and echocardiography will show valve distortions responsible, for example, for blood leakage. Electrocardiography will show ischemic changes due to endocarditis. If the diagnosis is confirmed, it’s time for 4-6 weeks of antibiotic therapy combined with a hospital stay. Sometimes it is not possible to control the infection or the damage to the valves is too great, in which case cardiac surgery is necessary.