Infective Endocarditis(IE; Bacterial Endocarditis; Fungal Endocarditis)
by
Michael Jubinville, MPH DefinitionA thin layer of membrane covers the inner surface of the heart. Infective endocarditis (IE) is an infection of this membrane. IE can be life-threatening. It can also cause lasting damage to the heart. This can lead to serious health problems such as heart failure.
Clumps of bacteria can also form in the heart. These clumps can break off and travel through the blood to other areas of the body. It may block blood flow to important organs such as the brain, kidneys, or lungs. Causes TOPIE may be caused by:
The germs may be part of the normal environment in your mouth or on your skin. A cut in the mouth or skin will allow the germs to enter the blood. When the germs reach the heart, they stick to a surface. There, they can grow and damage nearby tissue. Certain conditions can make it easier for germs to stick in the heart:
Risk Factors TOPChances of IE are higher with:
Symptoms TOPSymptoms range from mild to serious. Factors that can influence symptoms include:
General symptoms may include:
Diagnosis TOPYou will be asked about your symptoms and health history. A physical exam will be done. The doctor will listen to your heart for a murmur. Testing will include:
Treatment TOPThe first goal of treatment is to stop the infection. This will decrease the chance of lasting problems. Further treatment may be needed if the infection caused damage to the heart. MedicinesMedicine will help to fight the infection. The type will depend on what is causing the infection. It may first be given through an IV at the hospital. The medicine may them be continued as pills at home. Treatment may last for up to 6 weeks. SurgerySurgery may be needed to:
Prevention TOPIE is rare, but some may have a higher risk. If you have a risk of IE the following may help decrease chance of an infection:
RESOURCES:American Heart Association https://www.heart.org Mouth Healthy—American Dental Association https://www.mouthhealthy.org CANADIAN RESOURCES:Canadian Dental Association http://www.cda-adc.ca/ Heart and Stroke Foundation of Canada https://www.heartandstroke.ca References:Antibiotic prophylaxis prior to dental procedures. American Dental Association website. Available at:
https://www.ada.org/en/member-center/oral-health-topics/antibiotic-prophylaxis. Accessed January 7, 2019. Infective endocarditis. American Heart Association website. Available at:
https://www.heart.org/en/health-topics/infective-endocarditis. Accessed January 7, 2019.
Infective endocarditis. EBSCO DynaMed Plus website. Available at:
http://www.dynamed...
. Updated November 22, 2017. Accessed January 7, 2019.
Thanavaro KL, Nixon JV. Endocarditis 2014: an update. Heart Lung. 2014;43(4):334-337. Last reviewed November 2018 by
EBSCO Medical Review Board
Michael J. Fucci, DO, FACC Last Updated: 1/7/2019 |
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