Endocarditis – causes of bacterial and rheumatic inflammation

Proven content

Endocarditis is an inflammation of the heart’s cavities, valves or larger blood vessels, and also foreign bodies that may be in the heart and system. Endocarditis occurs as a result of the action of bacteria that attack the body when the endocardium, the inner wall of the heart, is damaged.

What is endocarditis?

Endocarditis is a condition characterized by inflammation of the heart cavities, larger blood vessels and valves. The most common cause of this ailment are bacteria that attack our body in the event of damage to the endocardium (i.e. the inner wall of the heart). A diagnosis that is made too late can lead to both heart failure and peripheral embolism, resulting in inflammation of other organs or a heart attack. Endocarditis can be bacterial or rheumatic.

Endocarditis – causes

We can distinguish:

1. bacterial endocarditis,
2. rheumatic endocarditis.

In most cases, endocarditis is caused by bacteria in the body, mainly streptococci, but also staphylococci and gram-negative bacteria.

Bacterial endocarditis

Bacterial endocarditis may occur as a consequence of sepsis. It is caused by bacteria that invade the body and cause inflammation of endocarditis and inflammation of the heart valves on which they develop micro-inflammations. These, in turn, lead to the formation of ulcers, holes and distortions – heart defects. Pathogenic microorganisms usually circulate in the blood of such patients, and they can be grown on appropriate media.

Symptoms of bacterial endocarditis include:

1. heart murmurs
2. high fever,
3. general weakness of the patient,
4. accelerated heart rate,
5. getting tired quickly,
6. chills,
7. poty,
8. arthralgia,
9. anemia.

Rheumatic endocarditis

Rheumatic endocarditis is a disease that affects the endocardium and the entire heart muscle, incl. in the course of rheumatic fever – the inflammatory process affects the entire connective tissue. In the area of ​​heart valves, initially thickening and swelling of the subendocardial connective tissue layers develop, and at a later stage, cellular infiltrates in the valves themselves, papillary fibrin deposits and blood clots.

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Who is most at risk for endocarditis?

People at high risk of endocarditis include:

1. people with implanted artificial or biological heart valves,
2. people with acquired or congenital heart defects,
3. patients with a pacemaker,
4. separate suffering from hypertrophic cardiomyopathy,
5. drug addicts injecting drugs,
6. people undergoing cardiac catheterization.

Symptoms of rheumatic endocarditis

The general symptoms of all inflammation developing in the body are:

1. general weakness
2. headaches,
3. muscle and joint pain,
4. high temperature,
5. excessive sweating,
6. lack of appetite
7. sometimes chest pain, abdominal pain and back pain.

During the development of the disease, symptoms can be distinguished that are conditioned by the part of the heart that has been attacked by inflammation. It can be the left or right side. The typical symptom of endocarditis is quite rare – Osler’s nodules (painful lumps that appear on the feet and hands). Regardless of which ventricle was attacked, the doctor detects murmurs during auscultation.

Right side seizure hearts causes symptoms in the patient in the form of: weakness, fever, chills, sweating. In addition, chest pain and coughing are observed.

Left heart involvement – symptoms in the form of embolism predominate, such as: painful swellings on the fingers and toes, ecchymosis under the nails, faster fatigue, shortness of breath.

Endocarditis can cause the inflammation to spread throughout the body. One example is the central nervous system, which, when attacked, causes neurological disorders. In contrast, spleen infarction is characterized by abdominal pain on the left side. Symptoms of endocarditis may become apparent within the first few days of the onset of inflammation. Sometimes the ailment develops insidiously as a chronic disease. Then patients take various preparations that distort the picture of the disease and make it difficult to make a proper diagnosis.

Endocarditis and sepsis

Endocarditis is a consequence of blood poisoning, which is actually sepsis. Therefore, it is important to initiate treatment as soon as possible, as the patient may die. When bacteria get into the patient’s blood, they reach each part of the body in turn and in a very short time cause multi-organ failure (starting with the heart).

Diagnosis of endocarditis

The diagnosis of endocarditis is based on the detection of bacteria in the body through a blood culture. Other auxiliary tests include:

1. heart echo – helps to reveal changes in the structure of valves and possible blood leakage,
2. EKG test – reveals changes resulting from endocarditis, e.g. ischemic changes.

Endocarditis – treatment

The main treatment for endocarditis is antibiotic therapy. The treatment should be carried out under a specialist doctor’s supervision, in a hospital setting (it may last up to six weeks). If the taken antibiotics do not bring the expected benefits, a cardiac surgery is considered. This procedure is aimed at removing the tissues affected by inflammation and repairing the valves or implanting valve prostheses.

Prevention

In patients at risk – that is, with valvular prostheses and heart defects – it is important to remember to administer antibiotics during all medical procedures.