Endocarditis - Symptoms, Risk factors and Treatment

Endocarditis is the inflammation of the endocardium- the inner lining of the heart. It can also occur due to bacterial infection- known as infective endocarditis. 

Symptoms of endocarditis

The symptoms of endocarditis may resemble other infections, which makes it hard to differentiate and diagnose. They are not mostly severe and develop gradually. Some of the symptoms of endocarditis are;

• Cough
• Breathlessness
• Weakness and fatigue
• Increased sweating
• High heart rate (Tachycardia)
• Deep breathing
• Faster breathing (Tachypnea)
• Unintentional weight loss
• Pale skin 
• Fever or chills 
• Heart murmur- an abnormal sound of turbulent blood flow through the heart that a healthcare provider can hear through a stethoscope. 

Some other uncommon symptoms of endocarditis may include

• Blood in urine 
• An enlarged spleen that is tender upon touch 
• Tiny or red-purple spots over skin- due to leakage of blood vessels 

The signs and symptoms of endocarditis may vary from patient to patient. In some, it may be severe, while in some, there may be no such severe symptoms. Since they resemble other infections, the diagnosis of endocarditis can sometimes be difficult. If you have had prior heart surgery, recurrent tonsillitis, joint pain, or fever, you must visit the healthcare provider soon. 

Causes 

The main causative agent of endocarditis is bacterial overgrowth. Normally, we are exposed to various bacteria that surround us. They can enter our body through cuts, eyes, nasal passage, and mouth (through food and water). Often our immune system fights off them. But when the bacterial load is so much, the immune system can not get rid of them by itself. Hence, they can cause endocarditis. It occurs when bacteria reach your bloodstream. Since blood travels throughout your body, the bacteria can reach your heart too and infect its linings. However, other germs like viruses and fungi can also cause endocarditis. But most commonly, it is caused by bacteria. 

The causes of endocarditis can be;

• Injecting with a needle that is contaminated with bacteria or other germs. It is most common in IV drug abusers. 
• Heart valve damage that causes scarring of the heart, leading to the entrance of bacteria. 
• Tissue damage due to prior history of endocarditis. 
• Artificial valve replacement 
• Congenital heart disease
• Mitral valve regurgitation 
• Poor oral hygiene

Diagnosis 

To confirm the diagnosis of endocarditis, your healthcare provider may perform the following tests. 

1.ECG: 

This is done by putting leads on your chest and checking the rhythm of your heart.

2.Coronary Angiography: 

In this procedure, a catheter is inserted through an artery in your body, and the coronary arteries are checked for blockages.

3.Blood tests: 

Blood tests may be ordered for checking parameters that indicate an infection. They are done to confirm the diagnosis of endocarditis. 

4. Chest X-ray: 

Endocarditis can affect the lungs of the patient, causing collapsed lung or its infections. Therefore, it can also help in its confirmation. 

Prevention 

If you are already a heart patient, you need to take extra care of yourself. However, being healthy does not mean you do not need to take care of yourself. Make sure that you maintain good dental hygiene. Brush your teeth at least two to three times a day, and floss them frequently. Moreover, avoid undue exposure with needles like for body piercing and tattoos. Do not prolong the symptoms of any infection. If you have a complaint of fever and chills, visit the healthcare provider soon. Endocarditis can be prevented through an early course of antibiotics. 

If you have any valvular disease of the heart, make sure you take prophylaxis antibiotics before dental or any other interventional procedure. 

Conclusion 

Endocarditis is the inflammation of the endocardium- the inner lining of the heart. It can also occur due to bacterial infection- known as infective endocarditis. The main causative agent for it is bacteria. Therefore, preventing bacterial infections can help in the prevention of endocarditis too.