Heart Inflammation Endocarditis

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Endocarditis is  inflammation  of the endocardium — the inner lining of the heart chambers and valves. Endocarditis is a rare but life-threatening disease. In endocarditis, clumps of bacteria or fungi from another part of your body get into your bloodstream and collect on the endocardium. These clumps occur more often on the heart valves than on the heart chambers. Pieces of the clumps can break off and travel to different parts of the body, blocking blood flow or spreading infection.

Causes

Causes of endocarditis include bacteria in the blood and abnormalities in the endocardium layer.

• Bacteria in the blood can come from bacterial infections in other parts of the body, such as urinary tract infections (UTIs), gum infections, or surgery.
• Abnormalities in the endocardium layer of the heart can make it more likely for bacteria to build up.

Risk Factors

Endocarditis is usually caused by an infection in the heart. Infections can be caused by bacteria, viruses, or fungi. Risk factors for endocarditis include:

• Factors that raise the risk of bacteria in the blood
  • Using IV drugs
  • Prosthetic heart valve
  • Poor dental health
  • Gum disease
  • Urinary tract infection (UTI)
  • Surgery
• Medicines or medical conditions that weaken the  immune system
• Heart conditions, especially those that involve heart valves
  • Congenital heart defects
  • Heart valve diseases
  • A history of endocarditis

Men are affected twice as often as women, and older adults have a higher risk than younger adults.

Symptoms of endocarditis may develop slowly, or they may start suddenly. Symptoms can vary from mild to severe. Common symptoms of endocarditis include:

• Fever
• Heart murmur or abnormal heart sounds
• Fatigue
• Heart problems like heart valve regurgitation and heart failure
• Blood in the urine
• A spleen that is larger than normal
• Stomach pain
• Chest pain
• Cough, with or without the presence of blood
• Loss of appetite and weight loss
• Muscle, joint, and back pain
• Night sweats
• Pain at the spot of a cardiac device, such as a pacemaker, which may mean it is infected
• Shortness of breath
• Skin changes, which may be tiny reddish-purple spots from broken blood vessels, red or purple bumps, or flat red spots on your palms or the soles of the feet

Often, diagnosis is based on the presence of a fever and heart murmur along with medical history. Blood cultures may identify and treat the exact bacteria, virus, or fungus that is causing the infection. Heart imaging tests such as echocardiography or cardiac MRI can help with diagnosis.

Treatment for endocarditis may include the following:

• Antibiotics treat bacterial infections. These are usually given through a vein (IV). Side effects of antibiotics depend on which antibiotic is used but may include diarrhea, problems with hearing, balance, kidneys, or decreased white blood cell counts. Some of these side effects may not occur until treatment is finished.
• Antifungal medicines treat fungal infections. Sometimes your healthcare provider may recommend lifelong oral antifungal treatment to prevent the infection from returning. Possible side effects of antifungal medicines include allergic reactions, diarrhea, dizziness, itching, blisters or hives, difficulty breathing, weight loss, and skin and jaundice .
• Heart surgery can remove infected tissue from the heart. Sometimes surgery may be needed to repair or replace damaged heart valves.
• Treat the source of bacteria, for example, bacteria from a urinary tract infection (UTI) or gingivitis.
• Remove the source of bacteria, for example, remove an infected pacemaker or implanted cardiac device.

You can take steps to prevent infections that may cause endocarditis.

• Avoid using recreational intravenous (IV) drugs.
• Wash your hands and skin regularly and wash cuts or scrapes right away to help prevent infection.
• Brush and floss your teeth every day and see your dentist regularly for check-ups.