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Infective endocarditis: Treatment, symptoms, advice and help

About infective endocarditis

Infective endocarditis is a heart disorder wherein the inner lining of the heart (endothelium) and the heart valves get infected. This is a serious condition which may lead to life-threatening consequences. However, infective endocarditis is a treatable condition and prognosis is good if diagnosed timely.

Infective endocarditis: Incidence, age and sex

Infective endocarditis affects 2 to 6 in 100,000 individuals. Individuals with congenital heart disease, rheumatic heart disease, valvular heart disease and intravenous drug abusers are most commonly affected.

Signs and symptoms of infective endocarditis: Diagnosis

The clinical features may be sudden or gradual in onset, depending upon the causative organism. The features are vague and generalised including fever with chills, joint pain, muscle pain, exhaustion, shortness of breath, night sweats and significant weight loss. Characteristic nail abnormalities (splinter haemorrhages) and skin problems (red spots on pals and soles) may also be manifested.

It is essential to get a comprehensive evaluation done by a specialist. A detailed physical examination may reveal a typical heart murmur and an enlarged spleen. Diagnostic tests include CT scan of the chest, echocardiogram of the heart (view heart problem) and blood culture (isolate offending micro-organism).

Causes and prevention of infective endocarditis

Infective endocarditis results from either bacterial (commonly) or rarely fungal infections in the blood which travels to the heart tissue. Subsequently the micro organism settles itself on the inner lining of the heart or the heart valves. This may progress to infected clot formation within the heart which may proceed to fragmentation and subsequent spread to other parts of body along with blood flow. The common pathogenic bacteria involved in infective endocarditis include streptococcus viridans (commonest), staphylococcus aureus and enterococcus which may enter the blood circulation through dental procedure or surgery. It is advisable to prescribe antibiotics in susceptible individuals before minor surgery or dental procedure.

Infective endocarditis: Complications

The complications of infective endocarditis may affect the heart and even other organs. The most fatal complication includes congestive heart failure which may end in death. Other cardiac (related to heart) complications include damage to the valves. If the clot breaks off, it may travel to other parts of body, causing damage to various organs including the kidneys, the liver and the brain.

Infective endocarditis: Treatment

The appropriate management of infective endocarditis requires hospital admission. Subsequently, a high dose of antibiotics are administered intravenously for about 2-4 weeks. The course of treatment may be extended further if the condition of the individual is serious. Timely diagnosis and treatment of infective endocarditis carries a good outlook. Severely damaged heart valves would require replacement. Surgical procedure of heart is needed in such individuals. Moreover it is essential that the affected individual maintains a strictly regular follow-up with the consulting doctor.