Eradicating Endocarditis

A cold sweat grips you as you sit at your kitchen table. You have a fever that just won’t quit—103.8. You think you have the flu but what you may have is far more serious. You could have endocarditis.

Endocarditis is an infection that affects the lining and valves of the heart. The condition is divided into two categories: acute and subacute. Acute endocarditis comes on rapidly, makes a person quite ill quickly and causes rapid heart damage. It often happens to a normal heart. Subacute endocarditis, while a serious infection, does not carry as dire a prognosis as acute endocarditis does. People with it often are up and about but don’t feel up to par. They have a low-grade fever that lingers. Their heart lining and valves are infected with bacteria that often comes from somewhere within their own body, like the mouth.

With subacute endocarditis, bacteria home in on already damaged heart valves. This type of endocarditis is almost successfully treated with intravenous antibiotics. Treatment can be prolonged—one or two months.

In developed countries, the incidence of endocarditis ranges from 2.6 to 7 cases per 100,000 population per year. The median age of patients with endocarditis is 58 years.

Some risk factors that you should watch out for include having an artificial heart valve and having had one episode of endocarditis already. A heart valve that has been damaged by rheumatic fever or an artificial heart valve is the target of bacteria that gets into the blood. They find such valves to be a place of sanctuary, and they multiply and grow on the valves. There, they are less susceptible to the body’s attack on them.

The condition can start under even the most innocent circumstances—a routine teeth cleaning, a skin infection, getting an infection from a popcorn hull stuck in the gums—but it can have deadly consequences. Bacteria enter the bloodstream and settle in the heart, growing on the valves and damaging them. Symptoms usually appear about two to four weeks after an infection starts, and may progress rapidly.

In the most extreme cases, weakened heart valves may leak and cause heart failure. And endocarditis may carry other risks as well. Bacteria grows on the valves in structures called vegetation. The problem with vegetation is that those things can break off and go anywhere in the body. The dislodged bacteria can cause strokes, interfere with vision when they lodge in the eye, or cause spots and pain in other parts of the body.

Endocarditis can be hard to diagnose. Early symptoms resemble the flu—fatigue, achiness, fever and chills—patients may not seek medical help immediately. When heart valves are affected, patients become short of breath and may have chest discomfort. Those symptoms often send people to the doctor, but even then may be confused for other conditions.

Endocarditis is diagnosed through blood tests and a special examination called “cardiac ultrasound.” The long treatment is standard for endocarditis. Patients typically require about four to six weeks of intravenous antibiotic therapy to clear the infection.

Although the risk is high for patients with endocarditis for the condition to reoccur, the risk is not that great. In fact, your chances of another bout of the condition are actually quite small.

You will have to be on a schedule of antibiotics protection before any procedure where bacteria are released into the blood. This includes dental procedures. The same goes for urinary and digestive procedures. This will lessen the chances of a second go-around with endocarditis.

And if the valve isn’t leaky or narrowed, then you are expected to lead a normal life. Even if major damage has been done to the valve, surgical correction of such valves almost always allows a person to have a normal life span and lead an active life.