Symptoms and treatment of infectious endocarditis
Inflammation of the inner lining of the heart caused by an autoimmune or infectious agent is called endocarditis. The disease most often occurs at a young age. Mortality from endocarditis is from 10 to 40%. The main symptoms of bacterial endocarditis: intoxication and heart failure.
Depending on the cause, inflammation can be non-infectious or infectious. The most common cause of rheumatoid endocarditis is beta-hemolytic streptococcus.
Classification of non-infectious endocarditis:
- fibroplastic (Leffler);
- thrombotic;
- warty endocarditis;
- rheumatic;
- inflammation that occurs against the background of autoimmune heart diseases.
Infectious endocarditis, depending on the causative agent, can be fungal, bacterial, chlamydial and rickettsial. The basis of treatment of infectious endocarditis is antimicrobial therapy.
Types of endocarditis
For the purpose of systematization and to facilitate diagnosis, there are several types of classification of the disease, each of which reflects the features of the course of the inflammatory process. Infectious endocarditis, depending on the clinic, can be acute, subacute and chronic. Signs of acute endocarditis are symptoms of body intoxication.
Primary infective endocarditis is rare. The explanation for this is simple: healthy heart valves that get infected are less susceptible to infectious agents.
In case of secondary infectious endocarditis, the causative agent of the disease gets on the damaged valves. Blood stagnation and narrowing of the valves contribute to microscopic damage to the inner lining of the heart, where infection easily penetrates.
Mitral and aortic valve endocarditis
Mitral and aortic valves are most often affected with infectious endocarditis. The first characteristic symptom of the disease is fever with subfebrile indicators, night sweats and chills. The second manifestation is the presence of neurological symptoms. The speed of growth and the severity of symptoms are directly related to the virulence of the microorganism. The most dangerous complication is arterial embolism.
Symptoms of bacterial endocarditis
Specialists distinguish between specific and non-specific manifestations of the disease. The latter include an increase in temperature over 38 degrees, chills, fatigue, weakness and pain in the joints. Characteristic non-specific symptoms are warm dry skin, sharp enlargement of the spleen.
Specific manifestations:
- heart failure and signs of heart failure (shortness of breath, heart pain, tachycardia);
- neurological symptoms;
- ischemia of abdominal organs and limbs;
- hemorrhagic rashes in the form of petechiae;
- enlargement of the liver.
Clinical recommendations for endocarditis will be discussed later.
Diagnostics
The diagnosis of such a terrible disease is made on the basis of the examination of the patient, the results of laboratory tests and the data of bacteriological research. From additional methods, it is advisable to use X-ray, ultrasound, computer tomography, MRI, echocardiography and ECG. The diagnosis of "infective endocarditis" is made after confirmation of the patient's presence of diagnostic criteria for endocarditis.
The examination is carried out by a therapist or cardiologist. History taking, general examination, listening to heart sounds (auscultation), percussion (beating the heart through the chest wall) and palpation are all used during the initial patient visit.
Laboratory studies show the following: general blood test - the leukocyte formula is shifted to the left, obvious signs of anemia; urine analysis - increased protein and leukocytes.
Bacterial tests are recommended for suspected infectious endocarditis.
Diagnosis of endocarditis in children has certain features.
Treatment
The patient is hospitalized for suspected endocarditis. Treatment depends on the type of disease. Treatment of subacute infective endocarditis should begin with taking antibacterial drugs. Antibiotics, which are prescribed in large doses, are taken for at least 10 days.
The main directions of endocardial inflammation therapy include immunocorrection, a course of antibiotics and surgical treatment.
Immunocorrectors are prescribed to neutralize microbial toxins circulating in the bloodstream. Antibiotics are used in high doses, most often in the form of droppers. Surgical intervention in endocarditis is justified in the presence of an intracardiac abscess, the growth of heart failure and the ineffectiveness of antibiotic therapy.
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Consequences and complications of the disease
The main complications of endocarditis of infectious etiology are thromboembolism, chronic heart failure and prolonged infection.
Thromboembolism - blockage of a blood vessel by a blood clot. This complication is one of the main causes of mortality.
Chronic heart failure is a condition in which the heart cannot fully perform its function. With correct therapy, the prognosis for the patient is favorable.
Prolonged infection is the most common complication of mitral and aortic valve endocarditis. With long-term circulation of pathogenic microbes in the blood, the risk of infection of other organs is extremely high.
Prevention
Prevention of septic endocarditis is timely remediation of foci of infection, high-quality treatment of staphylococcal infections, mandatory use of antibiotics after any surgical intervention and dispensary observation of narrow specialists in the presence of chronic diseases.
Take care of your health and remember that disease is better prevented than cured.
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