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Home :: Cardiology Disorders

Infective Endocarditis

 

Acute Myocardial Infarction
Aortic Stenosis
Atrial Fibrillation
Atrial Flutter
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Infective Endocarditis
Ischamic Heart Disease
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Paroxysmal Atrial Tachycardia
Rhematic Fever
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Wolf Parkinson White Syndrome

Infective Endocarditis is a microbial infection (if damaged heart valves of rheumatic origin and of the endocardium of the heart (the inner lining). Infection by staphylococci and streptococci is being dissected at the molecular level. New ideas for antimicrobial agents are being developed.These novel insights should help redefine preventive and therapeutic strategies against infective endocarditis. The bacteria that cause subacute bacterial endocarditis nearly always infect abnormal, damaged, or artificial valves. It can be life-threatening. It can permanently impair the heart valves. This can lead to serious health problems, including congestive heart failure

Endocarditis is an inflammation of the inner layer of the heart , the endocardium .Infective endocarditis affects twice as many men as women of all ages but 8 times as many older men as older women. It has become more common among older people: More than one fourth of all cases occur in people older than 60. Infective endocarditis is an infection of the lining of the heart's chambers (called the endocardium ) or the heart's valves. Bacterial endocarditis (also referred to as infective endocarditis, SBE) occurs when germs (especially bacteria) enter your blood stream and attack the lining of your heart valves. Bacterial endocarditis causes growths or holes on your valve or scarring of the valve tissue, most often resulting in a leaky heart valve. Risk factors for children and young adults include birth defects, particularly a defect that allows blood to leak from one part of the heart to another. One risk factor for older people is degeneration of the valves or calcium deposits in the mitral valve (which opens from the left atrium into the left ventricle) or in the aortic valve (which opens from the left ventricle into the aorta).

Endocarditis is an infection that invades the innermost lining of the heart - the endothelium. Infective endocarditis refers specifically to infection of the lining of the heart, but the infection usually also affects the heart valves, muscles of the heart, and any birth defects that involve abnormal connections between the chambers of the heart or its blood vessels. This apparent paradox is explained by a progressive evolution in risk factors; while classic predisposing conditions such as rheumatic heart disease have been all but eradicated, new risk factors for infective endocarditis have emerged.These include intravenous drug use, sclerotic valve disease in elderly patients, use of prosthetic valves, and nosocomial disease. So if an organism (such as bacteria ) establish hold on the valves, the body cannot get rid of them.

Causes of Infective Endocarditis

The common Causes of Infective Endocarditis :

  • The infection that leads to endocarditis can be caused by bacteria, fungi, or other microorganisms that enter your bloodstream.
  • The infection can cause growths on the heart valves, the lining of the heart, or the lining of the blood vessels. These growths may be dislodged and send clots to the brain, lungs, kidneys, or spleen
  • Urinary procedures, such as having a catheter in your bladder.
  • Having immune system problems, such as HIV infection, certain types of cancer, or an organ transplant.
  • Saureus is the most common bacteria found in patients with IVDA IE. Groups A, C, and G streptococci and enterococci are also recovered from patients with IVDA IE.
  • As the illness progresses, small dark lines, called splinter hemorrhages , may appear under the fingernails.
  • The organisms that cause NIE obviously are related to the type of underlying bacteremia.
  • But if the heart has certain abnormalities, in which blood flow is obstructed or abnormally pooled (i.e., cardiac arrhythmias or valvular defects), the bacteria can lodge there and cause an infection.

Symptoms of Infective Endocarditis

Some are common Symptoms of Infective Endocarditis :

  • Weakness
  • swelling of feet , legs, abdomen
  • Fever
  • Chills
  • skin spots, red - on the palms and soles, called Janeway lesions
  • Night sweats, may be severe
  • Fatigue
  • weight loss
  • Muscle aches and pains
  • Heart murmur
  • Shortness of breath with activity
  • Night sweats (may be severe)
  • Muscle aches and pains
  • Shortness of breath with activity

Treatment of Infective Endocarditis

Here is the list of the methods for treating Infective Endocarditis :

  • Long-term, high-dose antibiotic trearment is required to eradicate the bacteria from the vegetations on the valves.
  • Treatment is usually administered for 4-6 weeks, depending on the organism.
  • Hospitalization is required initially to administer intravenous antibiotics.
  • If heart failure develops as a result of damaged heart valves, surgery to replace the affected heart valve may be indicated.
  • However, there is new evidence to suggest that certain kinds of bacterial infections of prosthetic valves can be treated with just antibiotics.
  • Surgical removal of the valve is necessary in patients who fail to clear micro-organisms from their blood in response to antibiotic therapy, or in patients who develop cardiac failure resulting from destruction of a valve by infection.
  • Complications such as heart failure , and renal failure should be treated with medications and dialysis respectively.
  • Surgery is often required for treatment of metastatic infections (eg, cerebral and other types of aneurysms and macroabscesses of the brain and spleen).