Definition and causes
Endokarditis is an inflammation in endokardiet, which is the skin, holding the inside of the heart, ie. heart chambers and heart valves.Infectiousendokarditis due to infection with micro-organisms (bacteria, viruses, fungi).
Normally endokardiet protects against the microorganisms that have penetrated into the blood, can piggy-solid and grow in the heart. But if the membrane becomes damaged, for example. in connection with damage to a heart valve, a congenital heart disease, or if it has been implanted an artificial heart valve, micro-organisms have the opportunity to settle and grow in that site.
Usually, the bacteria whichstreptococciorstaphylococciand in rare cases, fungi that cause infectious endokarditis, and it is most commonly cardiac valve, hit (see the heart valves). The bacteria form a vegetation or colony, each consisting of størkningskomponenter own blood, thus inappropriate protects the bacteria against the body's immune system and hinders treatment with antibiotics. There may develop a chronic infection in which the vegetation and to deliver clumps of bacteria, which passes around with the blood and can
Normally harmless bacteria can get into the blood after a dental visit, especially in connection with tooth extraction, or after surgery on intestinal or urinary tract. Construction of urinary catheter (gummislange, introduced into the body through the urethra) or other catheters for administration of medication directly into the bloodstream may also result in bacteria in the blood.
Bacteria in the blood is usually not dangerous, but if you have weakened immune systems, for example. due to HIV, AIDS or a blood disorder, is particularly vulnerable. Infectious endokarditis seen mainly in people who already have heart (flip) disease or an artificial heart valve. If you have diabetes, have increased risk of infectious endokarditis. Injecting drug users have particular risk of infectious endokarditis the right side of the heart, because bacteria injected directly into the veins (veins), which manages blood
Symptoms of infectious endokarditis
Infectious endokarditis divided intoacuteandChronicendokarditis, depending on the symptom picture, which depends on the micro-organism which is, and how well the immune system can handle the infection.
Chronic endokarditisgives a picture disease, which is less specific than the acute endokarditis, and the symptoms are often slow in onset, which makes the disease harder to detect. Symptoms may include:
- Abnormal fatigue.
- Mild fever and night sweating.
- Weight loss due to reduced appetite.
- Small blood clots can form small point-shaped bleeding under nail, for oral or in the eye. Blood stopper can cause arterial embolism, or at worst a blood clot in the brain.
Acute endokarditisprovides more sudden symptoms, in addition to the above symptoms may also include:
- High fever.
- Emerging symptoms of heart failure.
If you have an increased risk of infectious endokarditis (see above), it is important to tell their doctor or dentist about the condition. By action where there is a risk of introducing bacteria into the blood, are treated with preventive antibiotics.
Chronic endokarditis is difficult to detect because the symptoms are often not related to heart disease. There might be a suspicion of the disease, if the doctor hears a heart murmur by listening to the heart with a Stethoscope. A blood test (a so-called blood culture) can reveal whether there are bacteria in the blood. An ultrasound examination of the heart (echocardiography) can reveal more bacteria grow, for example. on the cardiac valve and simultaneously determine whether heart valves or other parts of the heart has been damaged by in
Treatment of infectious endokarditis
Untreated, the disease is usually fatal, and it is important to contact your doctor if you have these symptoms.
Provide long-term (weeks to months) intravenously (directly into the blood vessels) antibiotic treatment. Even with medical treatment, there is a significant mortality rate, because the diagnosis is often made late in the process. If no improvement is seen within a few weeks, it may be necessary for an operation, which replaces the infected heart valve with an artificial heart valve. If you have successfully deployed a new heart valve, but can live quite normal with this for many years.