Infective endocarditis
Infective endocarditis is an infection of the inner surface of the heart, usually the valves. Signs and symptoms may include fever, small areas of bleeding into the skin, heart murmur, feeling tired, and low red blood cell count. Complications may include backward blood flow in the heart, heart failure – the heart struggling to pump a sufficient amount of blood to meet the body's needs, abnormal electrical conduction in the heart, stroke, and kidney failure.
| Infective endocarditis | |
|---|---|
| Other names | Bacterial endocarditis |
| A mitral valve vegetation caused by bacterial endocarditis. | |
| Specialty | Cardiology, Infectious disease |
| Symptoms | Fever, small areas of bleeding into the skin, heart murmur, feeling tired, low red blood cells |
| Complications | Valvular insufficiency, heart failure, stroke, kidney failure Blood clot in a lung artery (pulmonary embolism) Enlarged and painful spleen, kidney damage, damage to the distal extremities such as fingers and toes. |
| Causes | Bacterial infection, fungal infection |
| Risk factors | Valvular heart disease including rheumatic disease, congenital heart disease, artificial valves, hemodialysis, intravenous drug use, electronic pacemakers |
| Diagnostic method | Based on symptoms, blood cultures, ultrasound |
| Treatment | Antibiotics, heart surgery |
| Prognosis | 25% risk of death |
| Frequency | 5 per 100,000 per year |
The cause is typically a bacterial infection and less commonly a fungal infection. Risk factors include valvular heart disease, including rheumatic disease, congenital heart disease, artificial valves, hemodialysis, intravenous drug use, and electronic pacemakers. The bacteria most commonly involved are streptococci or staphylococci. Diagnosis is suspected based on symptoms and supported by blood cultures or ultrasound of the heart. There is also a noninfective form of endocarditis.
The usefulness of antibiotics following dental procedures for prevention is unclear. Some recommend them for people at high risk. Treatment is generally with intravenous antibiotics. The choice of antibiotics is based on the results of blood cultures. Occasionally heart surgery is required. The number of people affected is about 5 per 100,000 per year. Rates, however, vary between regions of the world. Infective endocarditis occurs in males more often than in females. The risk of death among those infected is about 25%. Without treatment, it is almost universally fatal. Improved diagnosis and treatment options have significantly enhanced the life expectancy of patients with infective endocarditis, particularly with congenital heart disease.