Endocarditis is an infection of the endocardium (internal membrane covering the heart), caused by the spread of a bacterium within the body.
Definition of endocarditis
Endocarditis is a rare infection of the endocardium (internal membrane, covering the heart), but potentially fatal. The main cause of endocarditis is an infection with a bacterium, circulating in the body through the bloodstream and reaching the heart.
Although the heart is a muscle generally well protected against infections, this is still possible in people:
- wearing a cardiac prosthesis
- with cardiac pathology
- presenting with hypertrophic cardiomyopathy, a disease where the cells of the heart muscle expand and encumber the heart chamber
- testifying to damage to the valves of the heart.
The prescription of certain drugs is also an additional risk factor for endocarditis.
Causes of endocarditis
Bacterial infection is the main cause of endocarditis. The bacteria initially infect the bloodstream. It thus gradually infects the different parts of the body, to the heart. The endocardium (internal membrane covering the heart), thus infected, causes the heart valves to be affected.
Small clumps of bacteria can be created at the site of the infection. These bacterial clumps can, in this sense, block the blood circulation and limit the arrival of blood in the heart. The heart, playing the role of pump, is driving in the distribution of blood to the whole body. As a result, disturbed circulation of blood can have serious consequences for the irrigation of other organs and thus lead to their deficiency.
The entry of the bacterium into the body can be done by various means:
- by mouth (brushing teeth, chewing food, etc.)
- by spreading an infected site (skin infection, for example)
- the intrusion of medical devices (syringe, catheter, dialysis tubes, etc.)
Risk factors for endocarditis
There are a number of important risk factors for endocarditis:
- the presence of an underlying cardiac pathology: valvular stenosis, valve regurgitation, etc.
- heart attack
- of high blood pressure
- rheumatic fever (a type of bacterial infection that can damage the heart)
- wearing a prosthetic valve
- hypertrophic cardiomyopathy
- intravenous drug therapy
- a fungal infection
Anyone may be concerned with the development of endocarditis. However, some people are at greater risk than others.
These include patients with underlying heart disease, high blood pressure, intravenous therapy, etc.
Evolution and possible complications of endocarditis
The heart plays a role of pump, allowing the irrigation of all organs of the body. As a result, disturbances or even a deficiency of the myocardium can cause a deregulation in the irrigation of the other organs of the body. In this sense, vital organs (kidneys, liver, brain, etc.) can suffer significant consequences due to a lack of blood, and therefore oxygen.
Symptoms of endocarditis
The symptoms of endocarditis can develop quickly (in a few days), as part of an acute endocarditis. In contrast, chronic endocarditis corresponds to a development of symptoms over the longer term: from a few weeks to a few months.
The main clinical signs associated with the disease are:
- febrile condition, with fever over 38 ° C)
- night sweats
- of headaches
- breathing difficulties
- general and chronic fatigue
- muscle and ligament pains.
Other, rarer symptoms may also be related to:
- the appearance of pimples and rashes
- the tarnished blood
- the appearance of nodules (buttons) on the fingers and toes
- the development of a state of confusion.
How to prevent endocarditis?
The prevention of endocarditis mainly concerns people whose risk is increased (with underlying cardiac pathologies, with high blood pressure, etc.). It is then advisable for these patients to limit as much as possible any exposure to a risk of bacterial contamination.
How to treat endocarditis?
In most cases of endocarditis, it can be treated by the use of antibiotics.
Hospitalization of the patient is usually necessary in the first phase of management. Continuation of treatment can be done at home.
The duration of antibiotic therapy is dependent 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, to determine the bacterium at the origin of the infection.
In the case of a fungal infection (by a fungus), antibiotic treatment is useless. The prescription of an anti-fungal will be the basis of the care.
In extreme cases of the disease, where damage to the heart is important, surgery may be necessary.