Endocarditis is inflammation of the heart’s innermost membrane (endocardium) or heart valve. In general, infectious endocarditis is the most common. In patients with heart disease (valve disease or congenital heart malformation, etc.), the blood flow is irregular and the inner lining of the heart is often damaged. At this time, if there are bacteria floating in the blood, they collect well in the wound area, where they re-inflame, causing damage to the lining or valve.
It is mainly caused by infections caused by staphylococcus, fungi, and streptococcus.
The patterns of infective endocarditis are very diverse. Acute endocarditis is similar to the symptoms of a cold, so the patient may have fever, cold sweat, muscle aches and less energy. Chronic endocarditis develops over the course of several months, which may include chills, fever, fatigue, weight loss, muscle pain, joint pain, cold sweat, and when heart failure occurs, the body swells, breathes, and pink sputum may appear. There is. The initial symptoms of infection endocarditis are often mild, with symptoms such as fever, joint pain, muscle pain, headache, chills, nausea or vomiting occurring only at around 40%. For this reason, if the fever of unknown cause persists for more than 4 to 5 days in a person with heart disease, the possibility of endocarditis of the infection must be borne in mind and checked by echocardiography.
Diagnostics and tests
1) Blood culture test
It is most important to identify the causative agent of infectious endocarditis. If there are bacteria in the blood, they can grow and reveal what the species is. After that, the cardiologist will choose an antibiotic that works for the bacteria.
It is a very important test for the diagnosis of infectious endocarditis. A cardiologist can check and diagnose the swelling (or bacterial mass) with ultrasound images, and check the condition and abnormality of the valve. Even a very small swelling may not be found well with a transthoracic echocardiography, so a transesophageal echocardiography is done as needed.
The basic treatment is to give antibiotics to remove bacteria in the blood and bacteria in the growth. If the causative bacteria have been identified by blood culture, an antibiotic effective for the causative agent of endocarditis should be selected and administered according to the antibiotic sensitivity test. Antibiotics to be administered vary depending on the invading causative agent, but must be administered intravenously because a drug with strong sterilizing power must be administered intravenously and continuous follow-up is required. Antibiotics are administered for 6-8 weeks, followed by blood tests and echocardiography. In some cases, heart valve surgery may be necessary in cases of severe damage to the heart valve due to infective endocarditis, severe symptoms of obstructive or insufficiency of the heart, or repeated drug thrombosis due to unsuccessful medication or edema.
Progress and complications
The most common complication is the heart. About ½ ~ ½ of all patients with infectious endocarditis have heart-related complications. The most common complications are heart failure and the formation of an abscess around the valve.
Patients with existing valve diseases, who have undergone valve replacement with mechanical valves, or patients with certain congenital heart diseases (ventricular septal defect, arteriovascular stenosis, aortic stenosis, etc.) are at greater risk of infective endocarditis. In addition, this risk is even higher if the patient has had endocarditis in the past. Therefore, if a patient undergoes dental treatment or urinary system procedures, he or she should talk to the cardiologist about his or her heart condition before the procedure. In addition, the patient should decide whether or not prophylactic antibiotic treatment is necessary by consulting a cardiologist.