Endocarditis is an infection of the endocardium (the inner membrane covering the heart), caused by the spread of bacteria within the body.

Endocarditis is a rare infection of the endocardium (inner membrane, covering the heart), but potentially fatal. The main cause of endocarditis is infection with bacteria circulating in the body, by the bloodstream and reaching the heart.

Although the heart is a muscle generally well protected against infection, this is still possible in people:

• wearing a heart prosthesis
• with cardiac pathology
• with hypertrophic cardiomyopathy, a disease where heart muscle cells enlarge and clutter up the heart chamber
• indicating damage to the valves of the heart.

Prescribing certain medications is also an additional risk factor for endocarditis.

Bacterial infection is the main cause of endocarditis. The bacteria initially infect the bloodstream. It gradually infects different parts of the body, right down to the heart. The endocardium (internal membrane covering the heart), thus infected leads to damage to the heart valves.

Small clumps of bacteria can form at the site of infection. These bacterial clusters can, in this sense, block blood circulation and limit the flow of blood to the heart. The heart, playing the role of pump, is the motor in the distribution of blood to the whole organism. As a result, disturbed blood circulation can have serious consequences on the irrigation of other organs, and thus lead to their deficiency.

The entry of the bacteria into the body can be done by different means:

• by mouth (brushing teeth, chewing food, etc.)
• by spreading from an infected site (skin infection, for example)
• intrusion of medical devices (syringe, catheter, dialysis tubes, etc.)

There are a number of risk factors for endocarditis:

• the presence of an underlying cardiac pathology: valve stenosis, valve regurgitation, etc.
• a heart attack
• high blood pressure
• rheumatic fever (a type of bacterial infection that can damage the heart)
• wearing a valve prosthesis
• hypertrophic cardiomyopathy
• intravenous drug therapy
• fungal infection

Anyone can be affected by the development of endocarditis. However, some people are at greater risk than others.

These include patients with underlying heart disease, high blood pressure, requiring intravenous therapy, etc.

The heart plays a role of pump, allowing the irrigation of all the organs of the body. As a result, disturbances or even a deficiency of the myocardium can cause deregulation in the irrigation of other organs of the body. In this sense, vital organs (kidneys, liver, brain, etc.) can suffer serious consequences due to a lack of blood, and therefore of oxygen.

Symptoms of endocarditis can develop rapidly (over a few days), in the setting of acute endocarditis. Conversely, Chronic endocarditis corresponds to the development of symptoms over the longer term: from a few weeks to a few months.

The main clinical signs associated with the disease resume:

• a febrile state, accompanied by a fever above 38 ° C)
• chills
• night sweats
• headache
• breathing difficulties
• cough
• general and chronic fatigue
• muscle and ligament pain.

Other, rarer symptoms may also be related:

• the appearance of pimples and rashes
• tarnished blood
• the appearance of nodules (pimples) in the fingers and toes
• the development of a state of confusion.

The prevention of endocarditis mainly concerns people at increased risk (with underlying cardiac pathologies, with high blood pressure, etc.). It is therefore advisable for these patients to limit as much as possible any exposure to a risk of bacterial contamination.

In most cases of endocarditis, it can be treated with the use of antibiotics.

Hospitalization of the patient is generally necessary in the first phase of treatment. Further treatment can be done at home.

The duration of antibiotic therapy depends on the severity of the disease. Indeed, the treatment can extend between 2 and 6 weeks.

A blood test is essential before any prescription of the antibiotic. And this, making it possible to determine the bacterium at the origin of the infection.

In the case of a fungal infection (by a fungus), treatment with antibiotics is unnecessary. The prescription of an anti-fungal will be the basis of the treatment.

In extreme cases of the disease, where damage to the heart is significant, surgery may be necessary.