Endocarditis is an inflammation of the endocardium. Endocarditis usually occurs as a manifestation of a general disease; rheumatic and septic endocarditis are most often distinguished by origin, in addition, endocarditis is syphilitic, tuberculous, traumatic, with myocardial infarction and other etiologies.
Most often, with endocarditis, heart valves are affected, less often – parietal endocardium of the heart cavities. Anatomical changes in the endocardium depend on the form of endocarditis. With rheumatic endocarditis, the endothelium of the heart valves is affected, followed by the imposition of thrombotic masses on them and the growth of granulation tissue.
Formations resembling warts (warty endocarditis) appear on the heart valves. Septic endocarditis is characterized by ulcerative lesions of the heart valves (ulcerative endocarditis) and the formation of blood clots on the damaged endocardium; Often there is a destruction of the heart valve.
After any form of endocarditis, persistent changes in the structure of the heart valve may remain that violate its function, i.e., heart disease develops. The disease is not a separate disease, but is a symptom of other heart ailments. It occurs at any age. Potential pathogens – about 128 species of microorganisms.
Endocarditis according to clinical and etiological signs is divided into:
- acute infectious;
- chronic and subacute;
- non-infectious thromboendocarditis;
- Leffler’s endocarditis;
Types of Endocarditis
Endocarditis is an internal inflammation of the lining of the heart. The heart, consisting of cavities (ventricles and atria on the right and left sides), separated by partitions, provides blood circulation, supporting the vital functions of the body.
The growth and reproduction of bacteria on the heart valves is the main cause of the disease.
Hence the name options:
Infectious (viral) endocarditis.
Staphylococcus aureus, as well as vermin streptococcus or enterococcus, is most often a provocateur of the disease of the inner layer of the heart. Inflammation of the heart of an infectious nature, which affects the membrane (endocardium) inside the organ, is called endocarditis.
The heart wall includes three muscle layers that perform important functions:
- pericardium (epicardium) – the outer layer, the serous membrane of the heart sac, preventing the excessive expansion of relaxed heart cavities;
- myocardium – a thick membrane of muscles that acts as a pump and provides rhythmic contraction of cavities, or blood circulation;
- endocardium – a thin layer lining the heart chambers from the inside, repeating their relief, and contributing to their smoothness.
Heart valves are folds of the deep layer of the endocardium that have a connecting structure and consist of elastic and collagen fibers, blood vessels, fat and smooth muscle cells.
According to the external and internal manifestations of the pathology, two types of endocarditis are distinguished: primary infectious and secondary infectious. Let us consider in more detail each type of pathology of the inner lining of the heart.
Primary endocarditis is the initial (first-occurring) inflammation of the endocardium caused by gram-positive and gram-negative bacteria: various cocci (strepto, gono, meningo), Koch’s bacillus, enterobacteria, yeast-like fungi.
As a result of inflammation, an overgrowth (vegetation) of connective tissue localized on the heart valves occurs. The resulting vegetation grows from small to significant sizes, is fragmented and spread by blood throughout the body.
The development of the primary form of endocarditis is promoted by surgical or traumatic injuries of the skin and mucous membranes, as well as various medical procedures. These include the removal of teeth or tonsils (tonsils), which provokes the development of streptococcal infection.
Secondary endocarditis – diffuse changes in connective tissue. Rheumatoid diseases and systemic infections (syphilis, tuberculosis) provoke its occurrence. The inflammatory reaction in this form is most pronounced.
The following factors increase the risk of endocarditis:
- congenital heart disease;
- artificial heart valves;
- previous endocarditis;
- heart transplant;
- intravenous infections of narcotic drugs (diagnosed by drug addicts);
- kidney cleansing sessions (hemodialysis);
- human immunodeficiency syndrome.
A patient belonging to a risk group, during various medical procedures and measures that increase the likelihood of infection, must necessarily warn of the presence of pathology. If you find problems in the functioning of the heart valves, be sure to seek the advice of a specialist about the risk of developing endocarditis.
Be on the alert: even if you are not worried or if a disease related to risk factors has been cured for a long time, you are still at risk of endocarditis.
Causes and risk factors
The main cause of endocarditis is the appearance and proliferation of bacteria on the heart valves. Hence the name of infectious or bacterial endocarditis. The most common variant of bacterial endocarditis is gram-positive microbial flora, or rather, staphylococcus.
Microbes enter the bloodstream in the following ways:
- Through wounds and damage to the mouth. The use of toothpicks, ingestion of rough food and banal brushing of teeth can lead to damage to the mucous surface of the mouth and the entry of bacteria into the blood. People with gums in poor condition are especially susceptible to infection.
- Infectious diseases. In the heart, bacteria can spread with tonsillitis and furunculosis, diseases of sexually transmitted and inflammatory processes in the intestine.
- Medical tools. Bacteria enter the body through poorly processed catheters, which are used when removing fluid from the body. Also, the infection can get during dental procedures through infected needles and other drugs. Infection of drug addicts occurs through the use of common syringes.
The normal immune system destroys any bacteria that enter the bloodstream. Otherwise, we would be sick after every small scratch. And even if the infection reaches the heart, the immune system suppresses it and the disease does not develop.
Many people with endocarditis have damage to their heart valves. And this is an ideal environment for the development of infection. These damaged tissues provide bacteria with nutrients, so they settle on the surface of the endocardium and begin to multiply.
The causative agents of infectious endocarditis:
- Staphylococci (more than 30% of cases);
- Streptococci (17 – 20%);
- Enterococci (about 20%) and other bacteria;
- Mushrooms (up to 3%).
The severity of the disease depends on the pathogen. With Staphylococcus aureus, death occurs in more than 60% of cases. And with a fungal infection, mortality exceeds 90%.
Among the factors contributing to the development of the disease, direct and general are distinguished. The first include:
- heart defects of various origins;
- damage to heart tissue, for example, during surgery;
- disturbances in the structure of the heart (individual anatomical features);
- the presence of foreign bodies, such as pacemakers, prostheses.
Any damage to the endocardium can become the location of pathogenic microorganisms. Common factors contributing to the development of the disease include:
- Carrying out procedures, studies that require penetration into the body. Such as prosthetics, prolonged wearing of a catheter, intravenous injection, surgery. Violations of the integrity of the skin open the path of infection into the body.
- Addiction. Drug addicts have a particularly severe course of infectious endocarditis with the likelihood of developing a septic form.
- Immunodeficiency caused by adverse conditions or prolonged use of drugs.
- Elderly age.
After primary endocarditis, the risk of a recurrence of the disease is high. Because in the heart there are consequences of the defeat of bacteria. The endocardium in these places is weakened and infection can resume.
Signs and symptoms
There are two types of infectious endocarditis. They differ in symptoms and the rate of deterioration of the patient’s condition. Acute infectious endocarditis is manifested by the following symptoms:
- The body temperature rises sharply. Jump to 40 °.
- The patient is in fever, perspiration intensifies.
- The symptoms of general intoxication of the body are pronounced. Such as an increase in the liver, severe headache, hemorrhages on the skin and mucous membranes, and a decrease in the rate of reactions.
- Perhaps the appearance of small painful formations on the palms, feet – Osler nodules.
- In places of infection, the development of abscesses is characteristic.
If, under the influence of bacteria, perforation of the walls of the heart valve occurs, then severe heart failure develops. Organs begin to fail. This is called septic syndrome.
With inflammation in the walls of the artery, there is a high probability of rupture, which is fraught with internal hemorrhages. It is especially dangerous if the vessel is in the heart or in the brain. Subacute infectious endocarditis does not develop so rapidly.
The patient can walk for months until a critical condition occurs that will help determine the problem. Symptoms that should alert:
- Unreasonable increase in body temperature by 1–2 degrees.
- Fast fatiguability.
- Weight loss.
- Decreased or lack of appetite.
- Heavy sweating.
- The development of anemia is a decrease in the number of red blood cells in the blood.
- When listening to the heart, you can distinguish a new noise or a change in the nature of the noise.
- Small spots similar to freckles appear on the skin, eye proteins, under the nail plates. These are the results of minor hemorrhages, as a result of throwing embolus into a small vessel – particles of bacteria, pus, blood clots.
- Possible blockage of arteries in the extremities, heart attack or stroke.
- Symptoms of acute heart failure appear.
Often the disease is asymptomatic, which complicates early diagnosis. But sometimes it arises suddenly. Many clinical manifestations can sometimes make diagnosis difficult, as the symptoms are similar to many cardiovascular ailments. The disease has both a protracted and acute course. Clinical signs are detected 2 weeks after infection.
An important symptom is fever, accompanied by chills and sweating. Temperature fluctuations are variable: from high for several weeks to months to slightly elevated for several days and the gradual normalization of temperature.
With endocarditis, the following symptoms are noted:
- headache, weakness, anorexia, arthralgia and other manifestations of intoxication;
- yellow skin, pallor, spots on the body, palms and feet and other changes in the skin;
- external changes in nails and terminal phalanges;
- arthritis of the joints of the limbs;
- damage to the heart valves (mitral and aortic);
- symptoms of exudative and dry pericarditis;
- an increase in the size of the lymph nodes;
- focal nephritis, renal infarction and other renal lesions;
- meningoencephalitis, cerebral thromboembolism and other defects of the central nervous system;
- progressive heart failure.
The nature of the course, clinical signs and outcome of the disease will depend on the current state of the human immune system and the severity of the disease process.
Signs of childhood endocarditis
The most common manifestations of endocarditis in children are fever and weakness, other symptoms are much less common. The incubation period (the time from the onset of bacteremia to the appearance of complaints) is usually less than 2 weeks, however, the diagnosis is sometimes made several weeks or even months later.
Early manifestations can be scarce and uncertain, some patients do not go to the doctor for a long time. The appearance or change of heart murmur in children is a rarity. The already unspecific clinical picture can be even more blurred by the appointment of short courses of antibiotics, and as a result, the diagnosis will be made late.
Fever, fatigue, or the progression of heart failure in a child with congenital heart disease should definitely suggest an infectious endocarditis.
Classic symptoms of infectious endocarditis:
- Roth spots (small retinal hemorrhages with a white dot in the center),
- Osler’s nodules (small painful red nodules on the fingertips),
- Janeway spots (painless hemorrhagic spots on the palms and feet),
- dashed hemorrhages (longitudinal dark red stripes on the nail bed) – were rare in all studies in children.
In the diagnosis of infectious endocarditis, several laboratory tests help. To identify bacteremia (which, as already mentioned, is usually permanent), several blood cultures are performed at intervals of 24–48 hours. Typical manifestations of infectious endocarditis are an increase in ESR and anemia.
In rare cases, infectious endocarditis in children occurs with aseptic meningitis. Clinical and laboratory data is not easy to interpret. In order not to leave patients who need it without treatment, and at the same time relieve those who do not need long-term parenteral antibiotic therapy, sensitive and specific diagnostic criteria are required.
In addition, they are necessary to compare the results of various studies. Such criteria were proposed in 1994 by the Department of Infectious Endocarditis at Duke University. They are based on clinical and morphological data.
The diagnosis of infectious endocarditis is considered confirmed if there are two main criteria, one main and three additional or five additional criteria. The main criteria are:
- the allocation of the characteristic pathogens of infectious endocarditis in repeated blood cultures;
- signs of endocardial damage according to echocardiography or according to auscultation (the appearance of a new noise of regurgitation).
Additional criteria include:
- congenital heart disease and other predisposing factors;
- immune disorders;
- Echocardiography and culture data that do not fit into the framework of the main criteria.
The parameters of each of the main and additional criteria are specified in detail in the literature. Echocardiography greatly facilitates the diagnosis. Transthoracic echocardiography in two-dimensional mode gives a resolution of about 2 mm, its sensitivity in the diagnosis of infectious endocarditis in children is 59–82%.
Transesophageal echocardiography is more sensitive in detecting vegetation and is especially useful in visualizing prosthetic heart valves, however, because of the risk of complications, transesophageal echocardiography is best used only if indicated:
- with insufficient informational content of transthoracic echocardiography,
- suspected damage to the right heart and the need for a thorough assessment of the status of prosthetic valves.
In other cases, transthoracic echocardiography is used.
Bacterial, septic and subacute septic endocarditis
Bacterial endocarditis is a type of endocarditis – it is an inflammatory process that affects the inner lining of the heart – endocardium. The body is responsible, first of all, for the elasticity of the valves and blood vessels, ensuring normal blood circulation.
The heart is arranged in such a way that the myocardium acts as an organ pumping blood, and the endocardium is a passage gateway for blood. The disease itself, as a rule, does not occur, but is a consequence of another disease, most often of an infectious nature.
There are different types of endocarditis:
Infectious or bacterial endocarditis.
It manifests itself as inflammation of the endocardium and the birth of new growths on the valves, forming its insufficiency. Primary infective endocarditis affects the usual unchanged heart valves.
Secondary IE – affects valves already modified by diseases. Basically, this is mitral valve prolapse, rheumatic heart disease. Changes can also be affected by artificial valves.
According to statistics, the incidence in men is observed 3 times more often than in women. Cardiologists note that drug addicts who are 30 times more likely to get sick than a healthy person get into the high-risk zone.
It occurs on the basis of untreated wounds in which suppuration and the inflammatory process began. There are also cases of septic endocarditis in the event of a difficult birth or a failed abortion.
Vegetations appear on the valves, leading to ulcerative endocarditis. Pathological processes occur in the vessels of the brain. Septic endocarditis is manifested for the most part not by endocarditis per se, namely, blood poisoning.
Subacute septic endocarditis.
The reason, in most cases, is an infectious disease or complication after surgery, including abortion.
Subacute septic endocarditis can be triggered by bacteria that inhabit the oral cavity and upper respiratory tract. Getting into the bloodstream, they become the cause of pathology.
Diffuse. Its other name is valvulitis.
Manifested in swelling of valve tissue. The cause, again, is rheumatism. As we can observe, almost all varieties of endocarditis appear as a result of rheumatism or infectious diseases.
Infectious endocarditis and other types
Infectious endocarditis – is the most common in the clinical course of the disease. Other major types are also distinguished. These include the acute type, which takes place over 2 months. The reason for its appearance is staphylococcal sepsis, wounds, bruises and various manipulations in the region of the heart associated with diagnosis and treatment.
In the acute form, infectious and toxic symptoms appear, there is a risk of blood clots and valve vegetation. Often it is possible to detect purulent metastases on different organs. Another type is subacute endocarditis, which lasts 60 days and appears as a result of improper treatment of the acute form.
With severe damage to the myocardium or malfunctioning of the heart valves, chronic recurrent endocarditis develops, which lasts more than six months. Most often, this form of the disease is recorded in young children from birth to a year with congenital heart defects, as well as in drug addicts and people who have undergone surgery.
A characteristic feature of infectious endocarditis is the formation of vegetation on the valves or parietal endocardium. Typically, endocarditis develops as a result of colonization by bacteria of initially sterile vegetations consisting of platelets and fibrin.
Sterile vegetation (aseptic thromboendocarditis) is formed at the site of endothelial injury due to a foreign body in the cavity of the heart or turbulent blood flow (for example, valve deformity), on scars and in severe extracardiac diseases (marantic endocarditis).
Insemination of vegetation occurs especially easily if the bacteria that caused the bacteremia have the ability to adhere to platelets, fibrin, fibronectin. The development of infectious endocarditis is accompanied by a further deposition of platelets and fibrin on top of bacteria, which are thus protected from phagocytes.
Vegetation with infectious endocarditis is more often formed in areas of high blood pressure (in the left parts of the heart) and where blood passes through a narrow hole from a high pressure to a low area at a high speed (for example, distal to the narrowed section of the aorta during coarctation).
Places where the pressure gradient is small (for example, the edges of the atrial septal defect) are rarely affected. In valve insufficiency, infectious endocarditis develops more often than with pure stenosis. With mitral insufficiency, vegetations are formed, as a rule, on the atrial side of the valve, and aortic insufficiency on the ventricular side.
Due to the high speed of blood flow, infection and the formation of distant metastatic foci are possible.
Weakly virulent bacteria, such as green streptococci, cause infectious endocarditis of valves already deformed and affected by aseptic thromboendocarditis, while more virulent ones (Staphylococcus aureus, Streptococcus pneumoniae) also infect unchanged.
Transient bacteremia often occurs with bacterial infections and with manipulations with the violation of the integrity of the mucosa of the oropharynx, gastrointestinal tract, urinary tract, genitals. For example, after an injury to the tissues of the mouth, especially against the background of periodontitis, green streptococci often stand out from the blood, usually together with other representatives of the microflora of the oral cavity.
The likelihood and degree of bacteremia depends on the severity of periodontitis and the extent of the injury. It is usually not possible to identify the cause of bacteremia, when endocarditis caused by green streptococci has already developed. In 15-20% of patients, dental treatment precedes it.
Bacteremia caused by gram-negative bacteria or enterococci is often accompanied by surgery on the prostate gland, female genital organs, cystoscopy, bougienage or catheterization of the urethra.
More than 50% of patients with enterococcal endocarditis shortly before the disease underwent surgery or instrumental studies of the gastrointestinal tract, urinary tract or genitals. More than 35% of patients with staphylococcal endocarditis were preceded by distant purulent foci.
The clinical manifestations of infectious endocarditis are due to the development of vegetation and the immune response to infection. Abundant vegetation, especially with fungal endocarditis, can clog the valve opening.
The rapid destruction of the valves leads to their failure, which is typical for endocarditis caused by Staphylococcus aureus. In the process of recovery, cicatricial changes in the valves are formed with the development of stenosis or insufficiency.
As a result of purulent melting of the myocardium during infection, conduction disturbances occur, fistulas form (between the heart chambers, between one of the chambers and the pericardial cavity or main vessels), ruptures of chords, papillary muscles, and interventricular septum occur.
Separation of vegetation pieces causes an embolism of coronary arteries, cerebral arteries, arteries of the kidneys, spleen, liver, limbs, pulmonary artery (with endocarditis of the right heart), ischemic heart attacks and metastatic abscesses.
The septic emboli in vasa vasorum or the direct introduction of bacteria into the walls of arteries lead to the formation of septic aneurysms with their subsequent rupture. The most common septic aneurysms of cerebral arteries, aorta, Valsalva sinus, bandaged ductus arteriosus, superior mesenteric, splenic, coronary and pulmonary arteries.
The titer of antibodies to the pathogen in infectious endocarditis is usually very high, which contributes to the formation of circulating immune complexes and the development of glomerulonephritis (focal, mesangiocapillary or diffuse), arthritis, vasculitis with multiple manifestations on the skin and mucous membranes.
Embolism of small coronary arteries, myocardial abscesses, vasculitis due to the formation of immune complexes lead to myocarditis.
- Acute-warty endocarditis occurs with infections, intoxication.
Inside the valve, neoplasms appear, directed to the blood stream. The return-wart type is characterized by the formation of growths and thrombotic deposits inside the valve. It occurs against a background of deformity or sclerosis of the valve, as well as a consequence of rheumatism.
This variety is characterized by progressive inflammatory processes of valve tissue and can lead to heart disease. Often this disease occurs as a result of changes in the structure of the valve of one of the varieties of endocarditis.
Timely detection of the disease saves the patient’s life. For diagnosis, it is first determined whether the patient is at risk. Does it have heart problems and aggravating habits such as drug addiction. When examining a patient, attention is drawn to the condition of the skin and mucous membranes.
To exclude the presence of characteristic hemorrhages. The heart is heard for new noises. The pressure is measured. General blood and urine tests are performed. The disease is indicated by decreased hemoglobin, an increase in the number of leukocytes and an increased ESR (erythrocyte sedimentation rate).
With concomitant kidney disease, white blood cells, red blood cells, and protein are found in the urine. The main method for diagnosing infectious endocarditis is echocardiography or ultrasound of the heart. This study reveals bacteria clusters from 2 mm in size.
Biochemical and immunological blood tests are performed, coagulation indicators are determined. To identify the causative bacteria, blood culture is used for sterility. An ECG is performed – electrocardiography. The results of which evaluate the work of the heart. An indicative x-ray of the lungs and heart is indicative.
It is possible to carry out MRI – magnetic resonance imaging. Consultation of specialists is required. Treatment is carried out by a cardiologist.
The course of the disease is determined behind the main focus of infection, which led to developing sepsis. So, in a prolonged form, septic endocarditis may disappear after 8 weeks, but it can last up to 4 months.
Due to the possible transition of a weak form of pathology to critical, therapy of the disease is required after its detection. So, the treatment of infectious endocarditis is directed to the primary foci of inflammation.
Therapeutic measures are carried out with the possible inclusion of surgical intervention, followed by the appointment of antibiotics and glycosides.
Treatment of endocarditis occurs according to the scheme of the main methods of therapy, namely antibiotic therapy. At the same time, in the choice of the necessary antibiotic, the sensitivity of the released microorganisms from the bloodstream is taken into account. So, for the treatment of endocarditis, it is possible to prescribe maximum doses of long-acting drugs (7–9 weeks).
In addition, the main symptoms should be treated with antibiotics. For example, prescribe detoxification agents, preparations of cardiac glycosides, as well as those that have a thrombolytic property.
But there are cases in which this therapy is ineffective, and then a repeated blood test is carried out with the subsequent appointment of antibiotics of a different spectrum of action.
In the absence of positive therapeutic effects within three weeks, surgery will be appropriate in which the affected valve is removed, which is subsequently replaced by a prosthesis.
Antibiotics are the basis of treatment. In case of severe valve damage, patients are hospitalized for surgery.
Due to the fact that the causative agent of endocarditis is not always immediately apparent, treatment is started with semisynthetic penicillins or broad-spectrum antibiotics until the result of bacteriological examination.
The following antibacterial agents are recommended:
- zeporin + gentamicin sulfate;
- Ampiox or carbenicillin + gentamicin sulfate;
- oxacillin sodium salt + gentamicin sulfate.
- Antibiotics. These are drugs that directly fight the pathogenic flora. It is important to choose the right antibiotic. To do this, you need to identify the pathogen and determine which drug it is sensitive to.
The course of admission is 4 weeks, but can be extended to 8 weeks. More often antibiotics of the cephalosporin group are used.
For the prevention of blood clots, blood clotting drugs are prescribed – antiplatelet agents
If bacteria damage the heart valves, a person may experience symptoms of heart failure. Damaged valves cannot cope with the flow of blood and the heart does not pump blood properly.
Without surgery, such people will experience symptoms of insufficiency until the end of their lives, so it is better to have surgery.
The valves themselves are not able to recover, therefore, an operation is required to replace the damaged valve with artificial, pork or made of human tissue.
A natural valve will serve for a long time, but an artificial valve can cause blood clots, so the patient will have to take anticoagulants. The valve of the animal will last up to 10-15 years. If shortness of breath, swelling of the lower extremities, joint pain, headache, feeling of chills and fever are observed, all this can indicate a worsening of the infection.
You should immediately visit a doctor, since all these symptoms indicate heart failure.
Treatment with folk remedies
Alternative methods of treating endocarditis are used only in combination with the main methods of treatment, as supportive measures. They will help during the rehabilitation period and prevent relapse of the disease.
Celandine will help prevent a recurrence of the disease.
For a single use, half a teaspoon of dry celandine is poured with a glass of boiling water (200 ml) and insisted for half an hour. The whole glass should be drunk throughout the day. The duration of the course is 1 month.
Garlic and citruses are peeled, finely grated and mixed with honey. The product is hidden in a dark place with a low temperature for one week. They use the mixture for six months, one glass a day.
Infusion is drunk throughout the day. It combines well with antibiotics, as it enhances their effect and helps prevent complications.
To relieve endocardial inflammation, you can use a decoction of 60 g of dried St. John’s wort grass, 40 g of buckwheat flowers and 40 g of dry motherwort.
3 tbsp. l 1 liter of water is poured into such a collection, brought to a boil and left on low heat for 1-2 minutes. Then let the broth infuse for about an hour, filter and take 250 ml per day.
People with certain heart conditions are more prone to illness. They should take antibiotics to prevent some medical procedures.
This applies to patients who:
- have a heart valve on the heart;
- suffered a heart transplant or had valve problems;
- have congenital heart defects.
The best way to protect yourself from the disease is to follow the rules of hygiene:
- brush your teeth twice a day, use dental floss as needed, regularly go to the dentist;
- avoid unnecessary cosmetic procedures, in which any infection (piercing, tattooing) can be introduced into the blood;
- treat all wounds and abrasions, consult a doctor when suppuration of the wound, eliminate the foci of infection in the soft tissues.
To prevent endocarditis, it is necessary to avoid excessive physical exertion and strive to strengthen immunity. We must remember that any chronic focus of infection is a potential risk of endocarditis.
Therefore, do not delay the treatment of even such simple (commonplace) infections as tooth decay, chronic tonsillitis, laryngitis, tracheitis or sinusitis. This is especially important to remember for those patients who have a history of heart disease.
Patients with chronic heart disease and artificial valves need to be constantly monitored with medical supervision to prevent the development of endocarditis. They are considered patients at risk.
Antibiotics are prescribed to patients at risk of chronic infection with foci of any medical intervention associated with impaired tissue integrity (hemodialysis, removal of tonsils, teeth, adenoids, bladder catheterization, various endoscopic procedures).
If a person has heart disease, he is at risk. With interventions in the body, the doctor prescribes preventive drug treatment. At the slightest suspicion, you should consult a doctor for an examination.
Early detection of the disease contributes to a speedy recovery. Rehabilitation procedures after infectious endocarditis are prescribed individually in each case. Depend on the severity of the course of the disease.
They are aimed at eliminating the effects of intoxication, maintaining heart function and general strengthening of the body. Recovery is directly dependent on the timely detection of a problem. Treatment is carried out in a hospital under the supervision of doctors. Surgical treatment is often required.
Infectious endocarditis often proceeds with complications:
- Glomerulonephritis. Kidney disease of an infectious-allergic nature. Manifested by swelling, increased blood pressure, a decrease in the amount of urine per day.
- Embolism. Blockage of blood vessels. May occur in the brain, lungs, spleen, and other organs. As a result, the development of heart attacks and strokes.
- Pneumonia, pleurisy, lung abscess.
- Hepatitis infectious toxic origin.
- Damage to the kidneys, liver or spleen.
Endocarditis is a serious disease. The outcome of which is difficult to predict. Without treatment, death occurs after 1-6 months. Even with adequate treatment, mortality rates are high: from 30 to 70%. As a rule, after a transferred infectious endocarditis, an acquired heart disease is formed.
Perhaps the development of chronic renal and heart failure. The forecast is mostly unfavorable. Even before antibiotics were put into practice, in most cases the disease ended in death. Today, 30% of all cases are fatal.
Death occurs mainly from renal or heart failure, thromboembolism and intoxication. Almost complete cure is guaranteed with timely antibiotic therapy and accurate determination of the causative agent of the disease.
After treatment, pronounced residual sclerotic changes in the valves are possible. Disability returns slowly, irreversible changes in the functioning of the heart valve often develop.
Relapses of endocarditis can occur within a month after undergoing treatment. This indicates incorrect or insufficient antibiotic antibiotic therapy. A surgical approach is possible in further treatment.
The appearance of signs of endocarditis 6 weeks after treatment indicates a new infection of the patient. If a person has heart disease, he is at risk. With interventions in the body, the doctor prescribes preventive drug treatment.
They are aimed at eliminating the effects of intoxication, maintaining heart function and general strengthening of the body. Recovery is directly dependent on the timely detection of a problem. Treatment is carried out in a hospital under the supervision of doctors. Surgical treatment is often required.
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