Bacterial endocarditis: A heart infection to take seriously
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Bacterial endocarditis: A heart infection to take seriously
Every single day of our lives we are surrounded by bacteria. Bacteria are found everywhere – in the air, on food, plants, animals, in soil, water and just about every other surface, including your body. Not all bacteria are harmful; however some are formidable adversaries that if they get inside you, they can weaken your immune system causing sickness.
All of us have experienced illness from bacteria that can cause a sore throat or bronchitis. Usually after a few days of antibiotics, the symptoms of these illnesses disappear and you feel fine.
But when bacteria invade the heart, the results can be devastating. This can lead to a condition called bacterial or infective endocarditis (BE), a type of infection found in the valves and inner lining of your heart (called the endocardium). BE is not common, but can happen from another part of your body where bacteria have entered the bloodstream.
There are two types of BE:
1. Acute BE – develops suddenly and may become life threatening within days
2. Chronic BE – develops slowly over a period of weeks to several months
Why does BE pose a threat to the heart valves?
The heart valves are not supplied directly with blood. Therefore, the body’s immune response system, such as the infection-fighting white blood cells, cannot reach the valves through the bloodstream. If bacteria begin to grow on the valves, which occur most often in people with already diseased heart valves, it is difficult to fight the infection, whether through the body’s own immune system or through medications that relies on the blood system for delivery.
How do bacteria reach the endocardium?
Whenever bacteria enter the bloodstream, often through a small scratch in the gums that occur during brushing, heart valves may become infected. The microbes will attach to any damaged tissue on a valve or lining of the heart muscle, where they will attract platelets and other components of the blood and form colonies. The bacteria in these colonies known as vegetations, produce toxins and enzymes that kill normal cells and disintegrate tissue, further damaging valves preventing tissue from healing.
BE can occur in anyone however some people are at a greater risk than others. This includes people who have:
· A diagnosed heart valve problem
· A heart defect or heart murmur
· A past surgery on heart valves
· An artificial heart valve
· A heart transplant
· A history of IV drug use
· A history of endocarditis
Another possible cause of BE is dental work. This can include teeth cleaning, and some medical procedures, such as a colonoscopy can increase the risk of bacteria entering your bloodstream.
What are the symptoms of BE?
Bacterial endocarditis usually starts with a fever and perhaps even chills. Patients also complain of aching muscles and joints and lack of appetite. Other symptoms can include a rapid heartbeat, fatigue, night sweats or persistent cough or swelling in the abdomen, legs or feet.
Because these symptoms can also be indicators of many other health conditions, a diagnosis of BE can be easily overlooked.
How is BE diagnosed?
Based on your symptoms is what usually causes your doctor to suspect BE. Blood tests and an echocardiography or echo test will also need to be performed to make a definitive diagnosis.
Treatment of BE
Antibiotics are the main form of treatment for BE which usually consists of at least two weeks and as much as six weeks of high doses of IV antibiotics. Severe cases of BE may require surgery. But because BE is a complex, rapidly progressing disease, it is best treated by a multidisciplinary team of clinicians who understand the disease process and know how to treat it and its complications.
Is it possible to prevent or avoid BE?
You cannot always prevent BE. However you should talk to your doctor if you are at risk, especially if you have a history of valve surgery, have a prosthetic valve or have undergone a recent interventional procedure and have had dental work. If you do need dental work or a procedure, you may need to take an antibiotic to prevent getting BE. If can help keep bacteria from getting into your bloodstream.
If diagnosed with the flu or pneumonia, discuss with your doctor of the possibility of BE. To rule it out, blood cultures can be taken before being started on antibiotics.