Endocarditis: Decrease the risk by boosting immune system and improving oral hygiene

Endocarditis is an infection of the inner lining of the heart, known as endocardium. It usually occurs when bacterias enter the cardiac muscle through the bloodstream, while damaging the heart valves, along the way.

Although these bacterias can originate from multiple sources, including flesh wound, they are most often coming from the oral cavity. Gum disease is the leading cause of endocarditis

CAUSES

Besides poor oral hygiene and gum disease, other possible causes may include:

  • Skin infection
  • Intestinal disorder
  • Weak immune system
  • Fungal infection such as Candida

Infection of the heart muscle rarely occurs in healthy individuals. Bacterias usually attach to the rough surface such as on to the damaged heart tissue.

Also, invading bacterias are often destroyed by the immune system or they pass through without causing an infection, if the cardiac muscle and heart valves aren't damaged.

RISK FACTORS

There are several factors that can increase the risk of infection such as:

  • Certain heart defects
  • Heart transplant surgery
  • Abnormal or damaged heart valve
  • Artificial heart valve
  • Kidney failure
  • Use of unsterilized needles or catheter
  • Past history of endocarditis
  • Dental surgeries
  • Other surgeries and minor procedures which can damage the tissue through which bacterias can enter the bloodstream

SYMPTOMS

First symptoms are very similar to the common flu. In most cases, it develops slowly, over two weeks. However, if powerful bacterias are behind it or you have underlying condition, the symptoms can appear within a few days. They can include:

  • Fever, chills and paleness
  • Fatigue
  • Persistent cough
  • Shortness of breath
  • Weight loss
  • Heart murmur
  • Night sweats
  • Pain in joints and muscles
  • Bleeding under the fingernails or blood in the urine
  • Tiny purple and red spots under the skin, know as Petechiae
  • Enlarged spleen, swelling in arms or legs

If left untreated, bacterias that cause endocarditis can grow on the damaged tissue which can prevent heart valves from opening and closing properly.

Blood can start leaking  backwards, instead of being pumped forward thereby interrupting normal blood flow, while interfering with heart's pumping function.

DIAGNOSIS

The doctors will make assumptions based on the physical exam, medical history and your statements. If heart infection is suspected, additional tests can be performed, such as:

  • Blood test to check for bacterias in the bloodstream
  • Echocardiogram to check that heart valves are opening and closing properly
  • Chest X-ray to see if the heart has enlarged or the infection has spread to the lungs
  • Electrocardiogram (ECG) to evaluate electrical activity of the heart
  • CT or MRI if the doctor suspects that infection has spread to other areas of the body, including the brain

TREATMENT

Endocarditis is usually treated with antibiotics which can be administered intravenously or by IV. However, if bacterias have severely damaged heart valves, infection is caused by a fungus or you have an artificial heart valve, surgery may be required. 

PROGNOSIS

If left untreated, disease may lead to permanent heart damage, excessive formation of blood clots, heart attack, arrhythmia, heart failure and even death.

Besides heart related problems, if the infection spreads, it may cause renal failure, stroke or lead to formation of abscesses in the lungs, kidneys, brain as well as the heart which can cause further complications.

An acquaintance of mine suffered from serious case of endocarditis because of which he got down to 110 lbs (50 kg) and almost died. However, he got through it and to my knowledge, doesn't has serious repercussions.





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