Infective Endocarditis Complications, Prevention, and Treatment

Endocarditis is an infection of the inner lining of the heart chambers and heart valves. It is a condition where the fungi, bacteria or germs travel from other parts of the body to the heart through the bloodstream. The infection leads to inflammation of the heart lining, heart muscles, and heart valves. It is much better to adopt precautionary & preventive measures as soon as the warning signs appear.

Infective Endocarditis Prevention

To prevent oneself from infective endocarditis, it is best to limit exposure to any infection that may lead to the same. This must be practised even more if one has an increased risk of developing endocarditis or has a history of the disease.

Practice good oral hygiene

Oral and dental hygiene is a must for someone who is at high risk. Ensure any gum disease or abscesses receives treatment in time. Visit the dentist on a regular basis for check-ups. Brush and floss the teeth regularly.

Take care of the skin

It is mandatory to take care of the skin to steer clear of any sort of disease. Wash the skin with a bar of antibacterial soap as it lowers the risk of infection. Moreover, any form of cut or graze must be washed and cleaned off in time. If one has a skin infection, it is best to visit the doctor to understand the severity of the problem. Also, be careful while getting any skin piercing or tattoo as it may cause an infection. IV drug use increases the chances of IE, hence abstain from the same.

Antibiotics

The doctor may prescribe antibiotics in case the medical procedure is taking place at a sight in the body and where there are chances of an infection. These may include infection in

• gullet, stomach or intestines
• reproductive or urinary system
• mouth after a dental treatment

In such cases, ensure to take the antibiotics on time and as prescribed.

Infective Endocarditis Treatment

If the treatment is not provided on time, it may cause severe damage or even destroy the heart valves. Hence, after a diagnosis of infective endocarditis, treatment must be started at the earliest. While some cases may be easily treatable with antibiotics, a few other cases may require surgery to fix the damage to the heart valves. Following methods of treatment are usually adopted.

Antibiotics

The doctor may recommend a high dose of intravenous antibiotics - IV (through the vein) at the hospital after the patient is done with a few blood culture tests. Once the doctor has identified the organism causing the infection, he would decide on the most appropriate method of treatment. He may either put the patient on a single antibiotic dosage or combine a few antibiotics that fight the infection together. This might involve spending some time in the hospital so as the doctor can monitor the effect of the antibiotics. Before clearing the infection, IV antibiotics may take up to a week. While putting the patient on an antibiotic course, the doctor would brief them about the infection they are prone to:

• fever
• headaches
• chills
• joint pain
• shortness of breath

Also, if one develops diarrhoea, itching, rashes or joint pain, they must consult the doctor at the earliest as this may indicate that the body is having a reaction to the prescribed antibiotic. Moreover, one may also have shortness of breath or swelling in the legs, ankles or feet as it indicates heart failure.

Surgery

If the infection spreads and damages the heart valves, the symptoms and complications may go on for years. One may also require surgery to treat persistent infections and replace a heart valve with some damages. The doctor may also recommend surgery to treat fungal endocarditis. Depending on the severity of the condition, the doctor may recommend either repairing the valve or replacing it with an artificial valve made of cow, pig or human heart tissue. Apart from the natural heart valves, the doctor may use man-made materials (mechanical valve) for repair. 15-25% of the patient are recommended treatment by surgery. Surgery is recommended in the following cases-

• Symptoms/ Tests suggest heart failure- a serious condition where the heart isn't pumping blood around the body efficiently.
• Continued high temperature despite ongoing treatment.
• Endocarditis due to particularly aggressive fungi or drug-resistant bacteria.
• Presence of blood clots despite treatment with antibiotics
• Presence of a prosthetic (artificial) valve.
• Results of echocardiogram suggest a collection of puss or an abnormal passageway that is developing in the heart.

Some of the surgical procedures used to treat endocarditis are -

• Repair damaged heart valve
• Replacement of damaged heart valves with prosthetic ones
• Draining abscesses and repairing any fistulas developed in the heart muscle.

Infective Endocarditis Complications

The infection causes a lot of damage to the body that may result in a few complications. One of the major complications is the abnormal heart rhythm like blood clots, other organ injury and hyperbilirubinemia with jaundice. The infected blood may also cause emboli, clots to travel to other parts of the body. Some common organs that are affected include the kidneys, lungs, brain and bones, particularly the spinal column. The bacteria or fungi in the heart may circulate and affect the other organs of the body sometimes causing severe damage. Severe complications arising from endocarditis may result in a stroke or heart failure. If the treatment of endocarditis is delayed, complications may keep increasing in severity.

• The damaged heart valves increase the risk of heart failure.
• Arrhythmia or irregular heartbeat if heart rhythms are affected.
• Infection may spread from the heart to other organs.
• In case vegetations break off, they may travel through the bloodstream and lead to infections. Moreover, if the vegetation gets to the brain and gets stuck, it may cause stroke or blindness. A large part of the vegetation may also stick to the artery blocking the blood flow.