Endocard is the inner core of the heart muscle. It coats the heart chambers and covers the heart valves. If it is damaged, e.g. in the case of mitral insufficiency, bacteria – or, occasionally, fungus – can enter the damaged area via the bloodstream. As soon as the colonies are created, the bacteria multiply and continue to damage the place where they grow. Parts of these colonies can be separated and, as embolus, travel to her parts of the body via bloodstream, clogging the small arteries and preventing the flow of blood into the tissues that are othervise supplied by these arteries. Bacteriae can also enter the heart where they attack heart valves. By multiplying, bacteriae destroy tissue of the heart valves that is weakened and ineffective; this condition is called bacterial endocarditis. This damaging ultimately leads to cardiac decompensation.
There is no main, basic symptom that would warn you to suffer from this illness. You can have a temperature, but it will rarely be higher than 39 °C. You can also feel a sudden chill (especially when part of the bacterial colony is separated and forms an embolism), headache, pain in joints, exhaustion and loss of appetite. If the disease has affected the heart valves, symptoms of cardiac arrest may occur.
Other symptoms depend on the localization of the embolus. The patient may have a painful lump on the pads of his fingers or small bruises behind the nail. Emboluses are often held in the brain, which can cause temporary weakness of one side of the body or loss of vision. Almost no part of the body is safe from the attack of bacterial infection of the embolus.
Bacterial endocarditis is a rare disease, especially among children and the elderly. It is most common between the ages of 15 and 55. Endocarditis will be the cause of death in 1 case out of 250 000. Disease affects equally both men and women.
More than 50% of cases of bacterial endocarditis occur among people with heart failures, caused by rheumatic fever. Rheumatic fever has been less common in recent years, leading to a significant decrease in the number of patients who suffer from bacterial endocarditis. Other possible causes (but ot so common) are inherited heart failure and syphilis, and bacterial infection can sometimes occurs at the site of heart valve transplantation. Bacteriae can enter the bloodstream during minor operations, tooth extraction and some diagnostic tests, but it rarely leads to endocarditis. A greater danger is related to large heart operations.
Sensitive people – mainly those who already have a heart disease – generally get an antibiotic treatment, usually in tablets just before a general or dental surgery or if furunculosis or other skin infections develop, since it is vital to prevent endocard infections.
The heart can endure permanent damage if the bacterial endocarditis is not detected and is not treated shortly after the initial infection. Emboluses can permanently damage the brain and other parts of the body.
What to do?
If you suspect you have had a history of bacterial endocarditis, do not delay your visit to a doctor. Since the symptoms of this disease are many and varied, this illness may be substituted with a variety of other illnesses, so you will be able to help a doctor – if you have not been seeing him for a while – if you emphasize that you have or have had heart failure or heartburn or any other symptom that is usually associated with endocarditis.
If there is a possibility of bacterial endocarditis, your doctor will most likely send you to the hospital for diagnostic tests. They will take a sample of your blood for analysis and tests to see what kind of bacteria is the cause of your endocarditis.
Treatment depends largely on the type of bacteria that caused the disease. The doctor will choose the most effective antibiotic to suppress the infection. If endocarditis is diagnosed and effectively treated within six weeks after the initial infection, you have 90% chances of complete recovery. Bacterial endocarditis may also cause anemia, so your doctor will recommend you a treatment with iron supplement that you will probably take in the form of tablets.