Endocarditis: what is it, symptoms and treatment
Endocarditis – heart disease, which in most cases is a complication of any disease. As a separate disease endocarditis is quite rare, about 20 – 30% of all cases of this disease. Despite the fact that the disease today is less common than before, it still leads to serious complications and if untreated, mortality from endocarditis is 100%. It is therefore important to know the first symptoms of a pathology, principles of treatment and prevention of disease.
Endocarditis. What is it?
Is an inflammatory disease of the inner lining of the heart (endocardium), which is accompanied by damage to the valvular apparatus. Valves covered with excrescences (so-called vegetariani), which change their shape and disrupt the functions, formed the failure of these valves.
By nature (morphological form) endocarditis are primary and secondary. Primary endocarditis is a disease that emerged on the unmodified valves. That is, the infection is circulating in the blood that lingered on the leaves of a healthy valve and caused the inflammatory process. This form is very rare, because healthy valves are generally not susceptible to infection.
Secondary endocarditis is an inflammation of the inner lining of the heart, which occurs on the background of already damaged valves. Such damage can occur when heart defects (congenital in children or in adults acquired), autoimmune connective tissue diseases (rheumatic endocarditis), trauma valves (including after heart surgeries), the defeat of the heart valves allergens (allergic endocarditis) or toxins (intoxication endocarditis). In a separate group can be distinguished secondary endocarditis with sepsis (bacterial endocarditis).
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The most frequent form of pathology, which is found today, is infective endocarditis. Viral and fungal infections as the causative agent when endocarditis is very rare. The most common causative agents are bacteria, causing bacterial endocarditis. Typically, the primary focus of infection outside the heart muscle. Bacteria enter the heart valves the bloodstream, are deposited on the leaves, causing inflammation and growth of connective tissue. This overgrown tissue is called vegetariani. But the proliferation of connective tissue, can occur detachment, deposition of blood clots and fibrin. As a result, formed the so-called warts, and then formed verrucous endocarditis. Interestingly, the warts themselves no bacteria, unlike vegetaci.
Symptoms of endocarditis
All manifestations of this pathology can be divided into cardiac (common symptoms) and specific characteristic of a particular form of endocarditis. Common symptoms include:
- Shortness of breath. Manifests itself as rapid breathing and feeling short of breath after exercise. With the progression of the disease or untreated, dyspnea can occur at rest.
- The pain in the heart area. Is a rare symptoms of endocarditis. Often occurs in the later stages of the disease when part of vegetati can break away and clog a coronary artery, or in lesions of the endocardium in the region of the aortic valves.
- Palpitations (arrhythmia type of arrhythmia). In the early stages of the disease is a manifestation of intoxication when the blood comes the release of toxins, increase in temperature and reflex increased heart rate. In the later stages tachycardia is a symptom of heart failure.
- Fingers as «drum sticks» and nails in the form of «hour glasses». This is not typical for endocarditis symptoms. They appear in heart or vascular disease when the tissues lack of oxygen and nutrients. Connective tissue on the fingers and under the nail plate grows, thereby increasing the area of contact with blood vessels and blood.
- Pallor or cyanosis of the skin. Are also symptoms of heart failure and evidence of tissue hypoxia. Acrocyanosis (blue discoloration of nasolabial triangle, fingers, ears) appears during exercise or in the later stages of endocarditis.
- The weakness and fatigue. These symptoms are consistent with poisoning the body with toxins, and oxygen starvation of the brain, which occurs when cardiovascular failure.
Specific to infective endocarditis are the following symptoms:
- The increase in body temperature (fever), chills, profuse sweats. Temperature initially may rise to low numbers, then increase up to 38.5 – 39.5 degrees. The fever may be accompanied by fever and decrease in body temperature – increased sweating.
- A rash on the skin is evidence of destruction by infection of the vascular wall.
- Headache and muscle pain. These symptoms are manifestations of General intoxication.
Treatment of infectious endocarditis
After determining the cause (pathogen) infectious endocarditis prescribed medication. From the first hours of admission, the patient is prescribed antibiotics with wide spectrum of action. After establishing the type of pathogen and its sensitivity to antibiotic drugs can be changed. Receiving antimicrobial agents is a long process, it takes 4 to 8 weeks. Antibiotic canceled when the patient’s normal body temperature, return to normal blood counts, stops the growth of infection in the blood cultures and disappear complaints.
In addition to antibiotics to maintain normal heart function are assigned antihypertensive drugs, diuretics, cardiac glycosides and antiplatelet agents. Surgical treatment is indicated in persistent increase in heart failure, with accumulation of pus in the wings of the valves, with the development of endocarditis in patients with artificial valves or with a huge vegetarian, threatening education and separation of blood clots.
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Prevention of complications
The patient is advised to follow a diet with reduced fat and cholesterol, limited physical activity and stress, and regularly visit a cardiologist to monitor the condition of the valves and heart.