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Endocarditis Causes and Risks:
Endocarditis can involve the heart muscle , heart valves, or lining of the heart. Most people who develop endocarditis have underlying heart disease .
Bacterial infection is the most common source of
endocarditis. However, it can also be caused by viruses, fungi, or other microorganisms. In some cases, no causative organism can be identified.
Related topics:
Prevention:
Preventive (prophylactic) antibiotics are often given to people with predisposing heart conditions before dental procedures or surgeries involving the respiratory , urinary, or intestinal tract. Continued medical follow-up is advised for people with a previous history of endocarditis.
Symptoms:
Note: Endocarditis may develop symptoms slowly (subacute) or suddenly ( acute ).
Signs and Tests:
A history of congenital heart disease , intravenous drug use, or chronic localized abscess or infection, raises the index of suspicion. Physical examination may show an enlarged spleen ( splenomegaly ). The examiner may detect a new heart murmur, or a change in a previous heart murmur. Examination of the nails may show splinter hemorrhages . Eye examination may show retinal hemorrhages with a central area of clearing, called Roth's spots.
Tests:
Treatment:
Hospitalization is often required initially to treat administer intravenous antibiotics. Long term high dose antibiotic therapy is required to eradicate the bacteria from the heart chambers and vegetations on the valves. Therapy up to 6 weeks is not uncommon. The chosen antibiotic must be specific for the organism causing the condition. This is determined by the blood culture and the sensitivities tests.
Activity is restricted to bed rest initially, then it is gradually increased as the condition improves. No special diet is necessary, unless it is required because of an underlying heart disorder (such as a low-salt diet).
If heart failure develops as a result of damaged heart valves, surgery to replace the affected heart valve may be indicated.
Prognosis:
Early treatment of endocarditis generally results in a good outcome.
Complications:
Call your health care provider if you note the following symptoms during or after treatment:
This is a cross-sectional view of the interior of the heart. The valves, chambers, and associated vessels are labeled.
This is an illustration of the exterior of the heart. The arteries are colored blue and represent blood that is flowing into the heart. The veins are red and indicate blood flow out from the heart. The chambers are also labeled.
Janeway lesions are seen in people with acute bacterial endocarditis. They appear as flat, painless, red to bluish-red spots on the palms and soles.
Osler's nodes are tender, raised, red (erythematous) bumps in the pads of the finger. They result when bacteria from an infected heart lining or infected heart valves lodge in the finger pads. This picture shows an Osler's node on the index finger in the middle of the image.
Janeway lesions are seen in people with acute bacterial endocarditis. They appear as flat, painless, red to bluish-red spots on the palms and soles.
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