Endocarditis Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Endocarditis is an infectious disease caused by microorganisms in the inner wall of the heart (endocarditis) or heart valves. This infection generally occurs in a heart that is already experiencing problems, for example, a heart valve disorder.
The infection usually involves the heart valves (both natural and prosthetic heart valves). Endocarditis can also arise in the heart wall, for example in cardiac ventricular defects.
Symptom
The symptoms of endocarditis may be non-specific. Sufferers may complain of a fever without a clear cause. Heart murmurs are also a sign of a heart problem.
Various disorders in the anatomy of the heart often already exist and increase a person’s risk of developing endocarditis. Therefore, various heart diseases need to be investigated. These various disorders include patent ductus arteriosus (PDA), ventricular septal defect (VCD), and mitral valve prolapse.
On physical examination, murmurs or additional heart sounds may be found. The appearance of a murmur indicates valve damage. The most commonly affected heart valve is the tricuspid valve.
Infection can result in a mass of masses (called vegetations) consisting of microorganisms, fibrin, and platelets. This vegetation can break off and become emboli which can cause infection in various other organs. Embolism usually occurs frequently in large arteries, causing infarction or abscess in the organ concerned. Emboli or vegetation fragments can enter the bloodstream and spread to various organs such as the skin, spleen, kidneys, skeletal system, and lining of the brain.
Reason
Endocarditis can be part of rheumatic endocarditis, which is a streptococcal infection. Meanwhile, bacterial endocarditis can be caused by various microorganisms. Causative microorganisms include streptococci, enterococci, pneumococci, staphylococci, fungi, rickettsiae, and viridans streptococci.
Infectious endocarditis often occurs in rheumatic heart disease with fibrillation and heart failure. Infection often occurs in the mitral and aortic valves.
There are several risk factors for a person developing infectious endocarditis. For example the use of immunosuppressive drugs (suppressing the immune system), hemodialysis, cirrhosis of the liver, diabetes mellitus, and users of intravenous narcotic drugs.
Organisms that cause endocarditis generally enter the bloodstream from mucosal surfaces, skin or focal sites of infection. One of the trigger factors for infectious endocarditis is interference with the teeth and oral cavity. Broken teeth and holes can be a route for germs to enter blood vessels and eventually to the heart. In addition, there are several other things that can also trigger endocarditis, namely gynecological obstetric measures and inflammation of the respiratory tract.
Diagnosis
To determine the diagnosis of this disease must begin with a medical interview and physical examination. There are criteria that can be followed to diagnose endocarditis. This criterion is known as the Duke criteria.
Diagnosis according to Duke criteria can be established if two major criteria or one major plus three minor criteria are present.
Major criteria:
- Positive blood culture for infective endocarditis
- Evidence of endocardial involvement on echocardiography
Minor criteria:
- Fever over 38°C
- There are vascular phenomena (arterial embolism, intracranial hemorrhage, conjunctival hemorrhage)
- There are immunological phenomena (glomerulonephritis, Roth sports/red spots)
- There is microbiological evidence
- Echocardiographic findings
Treatment
The goal of endocarditis therapy is to remove microorganisms in the vegetation. This aims to deal with complications. Antibiotics are generally administered parenterally and must achieve high serum concentrations.
Selection of effective therapy requires knowledge of the susceptibility of the causative microorganism to form the basis for the choice of antibiotics. Examples of initial treatment options for endocarditis are the antibiotics vancomycin and gentamicin.
Prevention
Endocarditis prevention Some things you can do are to keep your mouth clean and don’t use syringes for non-medical use.