Download Endocarditis

ENDOCARDITIS
Lyndsey Sarpy
WHAT IS ENDOCARDITIS?
Endocarditis is an infection of the
endocardium (inner lining
of the heart)
SYMPTOMS OF ENDOCARDITIS
Endocarditis may develop slowly or suddenly,
depending on what is causing the infection
Fever, chills, and sweating are the classic
symptoms. They sometimes can be present for
days before any other symptoms appear. They
can come and go, or can be more noticeable at
nighttime.
 A new or changed heart murmur (abnormal heart
sounds made by blood rushing through the heart)
 Fatigue
 Aching joints and muscles
 Shortness of breath

SYMPTOMS OF ENDOCARDITIS
Paleness
 Persistent cough
 Swelling in feet, legs, or abdomen
 Unexplained weight loss
 Blood in the urine (either visible or found when
viewing under a microscope)
 Tenderness in the spleen (left side, just below the
rib cage)
 Osler’s nodes (red, tender spots under the skin of
the fingers
 Petechiae (tiny purple or red spots on the skin,
whites of the eyes, or inside of the mouth)

CAUSES OF ENDOCARDITIS
Endocarditis can involve the heart muscle,
heart valves, or lining of the heart. Most people
who develop endocarditis have a:
Birth defect of the heart
 Damaged or abnormal heart valve
 History of endocarditis
 New heart valve after surgery

CAUSES OF ENDOCARDITIS
Endocarditis occurs when germs enter the
bloodstream and travel to the heart. Bacteria cause
most cases, but fungi or other microorganisms may
also be responsible. Sometimes the culprit is one of
many common bacteria that live in the mouth,
throat, or other parts of the body.
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Everyday oral activities. Activities such as brushing your
teeth or chewing food can allow bacteria to enter the
bloodstream, especially if your teeth and gums are in poor
condition.
An infection or other medical condition. Bacteria may
spread from an infected area, such as a skin sore. Gum
disease, a sexually transmitted disease, or an intestinal
disorder, such as inflammatory bowel disease, also may give
bacteria the opportunity to enter the bloodstream.
CAUSES OF ENDOCARDITIS
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Catheters or needles. Bacteria can enter the body
through a catheter (thin tube that doctors sometimes use to
inject or remove fluid from the body). The bacteria that can
cause endocarditis can also enter the bloodstream through
the needles used for tattooing or body piercing.
Contaminated needles and syringes are a concern for
people who use intravenous (IV) drugs.
Certain dental procedures. Some dental procedures that
can cut your gums may allow bacteria to enter the
bloodstream.
Typically the immune system destroys bacteria that
make it to the bloodstream. Even if bacteria reach the
heart, they may pass through without causing an
infection.
TESTS AND DIAGNOSIS
The infection can mimic other illnesses in its early
stages. Various tests may be necessary to help make the
diagnosis:
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
Blood tests. The most important test is a blood culture
used to identify bacteria in the bloodstream. Blood tests
can also help identify certain conditions, including anemia.
Transesophageal echocardiogram. An echocardiogram
uses sound waves to produce images of the heart at work.
This type of echocardiogram allows the doctor to get a
closer look at the heart valves. It is often used to check for
vegetations or infected tissue. During this test, an
ultrasound devise is passed through the mouth and into
the esophogus.
TESTS AND DIAGNOSIS
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Electrocardiogram (ECG). The doctor may order this
noninvasive test if he or she things endocarditis may be
causing an irregular heartbeat. During an ECG, electrodes
that can detect electrical activity of the heart are attached
to the chest and sometimes to the limbs. An ECG measures
the timing and duration of each electrical phase in the
heartbeat.
Chest X-ray. X-ray images help the doctor see the
condition of the lungs and heart. The doctor can use X-ray
images to see if endocarditis has caused the heart to
enlarge or if the infection has spread to the lungs.
Computerized tomography (CT) scan or magnetic
resonance imaging (MRI). A CT or MRI scan of the
brain, chest, or other parts of the body if the doctor thinks
the infection has spread to these areas.
TREATMENT
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Hospitalization may be necessary at first to receive
antibiotics through a vein (IV). Blood cultures and
tests will help the doctor choose the best antibiotic.
Antibiotic therapy for 4-6 weeks to fully remove all
the bacteria from the heart chambers and valves.
Surgery to replace the heart valve is usually needed
when:
 The infection is breaking off in little pieces,
resulting in strokes
 The person develops heart failure as a result of
damaged heart valves
 There is evidence of more severe organ damage
PROGNOSIS
Getting treatment for endocarditis right away
improves the chances of a good outcome. More
serious problems that may develop include:
Brain abscess
 Further damage to the heart valves, causing
heart failure
 Spread of the infection to other parts of the body
 Stroke, caused by small clots or pieces of the
infection breaking off and traveling to the brain

PREVENTION
Because people with the following heart conditions
are at risk of more serious outcomes from
endocarditis, they may need to take preventative
antibiotics before certain medical or dental
procedures to prevent endocarditis:
 Artificial (prosthetic) heart valve
 Previous endocarditis infection
 Certain types of congenital heart defects
 Heart transplant complicated by heart valve
problems
PREVENTION
Practice good hygiene:
 Pay special attention to dental health – brush
and floss teeth and gums often, and have regular
dental check-ups
 Avoid procedures that may lead to skin
infections, such as body piercings or tattoos
 Seek prompt medical attention if any type of skin
infection develops or open cuts or sores do not
heal properly