Endocarditis
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| Endocarditis | |
|---|---|
| File:Blood culture negative endocarditis.jpg | |
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Fever, heart murmur, fatigue, night sweats, shortness of breath, chest pain |
| Complications | Heart failure, stroke, sepsis, glomerulonephritis |
| Onset | Gradual or sudden |
| Duration | Weeks to months |
| Types | N/A |
| Causes | Bacterial infection, fungal infection |
| Risks | Heart valve disease, congenital heart defect, intravenous drug use, prosthetic heart valve |
| Diagnosis | Blood culture, echocardiogram, CT scan, MRI |
| Differential diagnosis | Myocarditis, pericarditis, rheumatic fever |
| Prevention | N/A |
| Treatment | Antibiotics, surgery |
| Medication | Penicillin, vancomycin, gentamicin |
| Prognosis | Variable, depends on cause and treatment |
| Frequency | 3 to 10 per 100,000 people per year |
| Deaths | 20% to 25% mortality rate |
Endocarditis is an inflammatory pathology that predominantly impacts the endocardium, the inner lining of the heart. Though primarily stemming from bacterial sources, various other microorganisms or non-infectious triggers can induce this condition. Predominantly, heart valves become the focal point of this ailment, with a potential escalation to critical complications if not addressed in due time.[1]
Etiology and Predisposing Factors[edit]
Endocarditis can manifest from a myriad of microorganisms; however, bacteria such as streptococci, staphylococci, and enterococci are the most frequent culprits. A subtype, termed non-infective endocarditis, arises without concurrent infection, influenced by factors like lupus, cancer, or specific drug usage.[2] Predisposing factors include the presence of prosthetic heart valves, prior endocarditis episodes, congenital heart anomalies, and intravenous drug utilization.
Clinical Manifestations and Potential Complications[edit]
Clinical manifestations span a spectrum from fever, fatigue, weight loss, night sweats, to the auditory sign of a heart murmur. As the pathology advances, graver signs such as heart failure might surface. Complications encompass heart valve deterioration, heart failure, cerebral events like stroke, and systemic embolism.[3]
Diagnostic Approach and Therapeutic Interventions[edit]
For diagnosis, clinicians commonly resort to blood cultures to identify causative agents and employ imaging modalities like echocardiography for detailed visualization of heart valves. A well-established set of criteria, the Duke Criteria, amalgamates clinical, laboratory, and echocardiographic data for a conclusive diagnosis.[4] Treatment paradigms primarily involve prolonged antibiotic regimens, often necessitating in-patient care. In scenarios where antibiotics fail or the disease severity escalates, surgical interventions to repair or supplant damaged heart valves might be imperative.[5]
Prophylaxis[edit]
To thwart the onset of endocarditis, it is advisable to maintain dental hygiene and undergo periodic dental examinations since dental infections can be a precursor to endocarditis. Certain high-risk cohorts might also necessitate antibiotic prophylaxis prior to specific dental or surgical ventures.[6]
Related Topics[edit]
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- ↑ Baddour, LM."Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications".Circulation.2015;doi:10.1161/CIR.0000000000000296.PMID:26373316.
- ↑ Falcone, M."Infective endocarditis: a review of etiology and diagnosis".Current Infectious Disease Reports.2019;doi:10.1007/s11908-019-0671-4.PMID:30919142.
- ↑ Thuny, F."Risk of embolism and death in infective endocarditis: prognostic value of echocardiography: a prospective multicenter study".Circulation.2005;doi:10.1161/CIRCULATIONAHA.104.493155.PMID:16027258.
- ↑ Li, JS."Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis".Clinical Infectious Diseases.2000;doi:10.1086/313753.PMID:10770721.
- ↑ Wang, A."Contemporary clinical profile and outcome of prosthetic valve endocarditis".Journal of the American Medical Association.2007;doi:10.1001/jama.297.12.1354.PMID:17389203.
- ↑ Wilson, W."Prevention of infective endocarditis: guidelines from the American Heart Association".Circulation.2007;doi:10.1161/CIRCULATIONAHA.106.183095.PMID:17446442.
