Status: 06.02.2023 08:57
Endocarditis is an inflammation of the inner lining of the heart (endocardium). The causes can be varied. The most common symptoms are fever, chills, fatigue, loss of appetite and weight loss.
There are different forms of the disease. Infectious endocarditis is caused by bacteria, viruses, or fungi. Non-infectious (abacterial) endocarditis often occurs in connection with rheumatic or autoimmune diseases. There are also mixed forms. The vast majority of inflammation occurs in the heart valves; the wall of the atria and main chambers can also be affected more rarely.
Causes: Heart defects and weakened immune system
Endocarditis can have many causes. patients with congenital heart defects, Heart valve diseases or a predisposition from previous endocarditis diseases have an increased risk. People with weakened immune systems, drug addicts and people with artificial heart valves are also particularly at risk.
Infectious endocarditis is triggered by dangerous bacteria such as Staphylococcus aureus, which might get into the blood through open wounds, for example. The pathogens attack the inner lining of the heart and often form growths on the heart valves. There is inflammation. Over time, these can lead to damage and scarring of the heart valve.
Non-infectious endocarditis, on the other hand, occurs in people with certain previous illnesses, such as rheumatic fever or an autoimmune disease. The body’s own defenses often lead to inflammation of the inner lining of the heart. Blood clots can also form on the heart valve. Left untreated, endocarditis is almost always fatal.
Symptoms of endocarditis: fever, chills, pain
The symptoms of endocarditis depend on the type of inflammation and the extent of the damage in the heart. The most common signs are fever, chills, tiredness, loss of appetite and weight loss. Chest pain, breathing difficulties, joint and limb pain and skin rashes can also occur. In severe cases, heart valve damage can occur heart failure.
In the case of acute infective endocarditis, most of those affected suffer from fever and chills, heart murmurs, tachycardia, feeling cold and night sweats. Weight loss, joint pain and anemia are also common symptoms. In addition, there are sometimes spots and nodules on the skin or bruises under the fingernails. Tiny blood clots that are washed away can damage the kidneys or the brain and retinas of the eyes.
Diagnosis: echocardiography, laboratory tests, heart valve biopsy
Technical procedures such as echocardiography, but also laboratory tests for inflammation parameters and the examination of blood cultures for pathogens help in the diagnosis of infectious endocarditis. A urine test can also be helpful. However, a definitive diagnosis can only be made following a heart valve biopsy.
Treatment of endocarditis depending on the cause
The treatment of endocarditis depends primarily on its cause. In infective endocarditis, antibiotics (for bacteria) or antifungal drugs (for fungi) can be used to fight the pathogens. In noninfectious endocarditis, an underlying autoimmune disease is treated with immunosuppressive drugs. If a heart valve is already so damaged that it no longer closes properly, it usually has to be replaced with an artificial or biological heart valve.
How to prevent endocarditis?
Antibiotics can be administered as a precaution in patients with a high risk of endocarditis. This is important, for example, during dental procedures on the gums, where bacteria might get into the bloodstream.
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