Endocarditis is microbial infection of endothelial lining present inside the heart. Endothelium is thin layer of cellular membrane that lines the four chambers and the 4 valves of heart. Infection and inflammation in endothelial lining usually occurs in damaged areas of heart.
Bacteria from other part of the body such as throat and mouth spread via bloodstream and lodge on the damaged site, mostly the valves. If the condition is not treated, it can damage the heart valves and lead to major heart complications.
Endocarditis can be acute or subacute depending on the rapidity of development of the disease and virulence of the bacteria.Acute endocarditis mainly occurs due to staphylococcus aureus. Whereas endocarditis that develops over a period of weeks is due to bacteria of low virulence such as streptococcus viridians. It is called sub-acute endocarditis. Treatment consists of antibiotics and surgery.
Causes And Risk Factors For Endocarditis
Endocarditis is also known as infective endocarditis. The infective pathogen is bacteria, often staphylococcus organisms. Bacteria from other infected part of the body pass on through the bloodstream and attach to the inner lining of the heart or the damaged valves. Middle aged and elderly individuals are more prone to bacterial endocarditis.The disease is uncommon in children below the age of 2years.
Maintaining poor oral and dental hygiene allows the germs to multiply in the oral cavity. Gum disease, tooth decay are the areas through which the germs can get an entry into the bloodstream. People with prothetic valve are at greater risk of bacterial endocarditis.
The propensity of infection is high in illegal drug abusers who use intravenous route to administer drugs. People with HIV infection and other sexually transmitted infection are also susceptible to develop infective endocarditis.
Bacterial endocarditis can be secondary to skin infection. Medical procedures such as colonscopy, use of catheter, body piercing with unsterilized instruments increases the risk of endocarditis.
Symptoms Of Endocarditis
The disease commonly begins with fever, body ache, night sweat, fatigue, joint pains, and chills. The symptoms in the beginning stage often mimic those of flu. Soon after few weeks patient presents with anemia and weight loss. As the disease progresses, tiny red spots are observed on skin and oral cavity, conjunctiva and even on retina. This tiny red spots are indication of bleeding.
There is splinter hemorrhage under the nail with dark streaks especially in fingers but less common on toes. In severe cases signs of heart failure may be seen such as breathlessness, edema on face, legs, chest pain, blue skin and tongue etc. Small nodes on pulp of finger tend to occur in crops. They are called Osler’s nodes.
Diagnosis Of Endocarditis
Endocarditis is diagnosed by the physician after careful physical examination, medical history and tests. Physical examination will reveal altered heart murmur. Patient may have possible recent bout of infection or heart valve replacement surgery.
Certain blood tests such as blood culture, erythrocyte sedimentation rate, ECG, echo cardiogram and CT scan of heart are useful tests for diagnosis of infective endocarditis.
Treatment Options For Endocarditis
Endocarditis carries high mortality and morbidity risk if left untreated. Most important part of treatment is use of antibiotics. The microbes are deep seated; hence only bactericidal antibiotics are administered intravenously for a period recommended by the doctor, usually it is four to six weeks. It will help in destroying the microbes completely and prevent recurrence of infection. Most cases have good response to antibiotic treatment.
In addition patient has to take complete bed rest, maintain proper fluid intake to keep balance of electrolyte in the body.
Alternative therapies such as homeopathy has vast number of remedies such as spigelia, cactus, aurum met, kali iod, kali carb, calc carb etc. Since the system is based on theory of individualization, you have to consult a homeopath and take the specific medicine only after his recommendation.