Bacterial Endocarditis Heart Injury

Infection of the heart valves is known as bacterial endocarditis. The infection is most often caused by bacteria in blood. Bacterial endocarditis is a life threatening condition and can lead to a number of complications if it is not promptly treated. Endocarditis is very rare in individuals with healthy valves. Individuals at high risk for endocarditis are those with a damaged heart valves, artificial valve(s) or some type of inherited heart defect. Bacterial endocarditis may develop with symptoms right away or gradually. While the majority of cases of endocarditis are caused by bacteria, sometimes fungus may also be the cause.

In any case, the symptoms include fever, chills, fatigue, painful joints, shortness of breath, cough, skin rash, blood in urine, tender abdomen, or no appetite. Endocarditis can occur after brushing teeth in some individuals who have defective valves, after a blood infection, use of intravenous drugs or certain dental procedures. In most cases of bacterial endocarditis, the heart valves have been previously damaged and tend to attract bacteria which start to grow on the valve surface. When the condition is not treated it can lead to stroke, kidney failure, infections in other parts of the body, heart failure and even death.

The diagnosis of bacterial endocarditis requires blood tests and an ultrasound of the heart (echocardiogram). The finding of a new murmur is sometimes an indication that the valve is not functioning well. Once the diagnosis is made, treatment involves intravenous antibiotics. The antibiotics have to be administered for 6 weeks and repeat echocardiograms are performed to ensure that the valve damage is under control. However, in some cases the antibiotics fail to kill the bacteria and surgery may be required. Surgery to replace the heart valve in the presence of an infection can be life saving. Depending on experience of the surgeon, the valve may be replaced with a mechanical valve or an artificial valve made of cloth. In most cases it is only one heart valve which is affected but rarely two valves may have to be replaced. When an individual has a mechanical valve placed, he/she will need a blood thinning medication for life. Cloth valves do not need blood thinning medications but they do not last for more than 7-10 years.

All individuals who are at risk for bacterial endocarditis should carry a card or wear a bracelet to inform the health care providers of their illness. Moreover these individuals should also pay special attention to dental hygiene and avoid getting a tattoo or body piercing. Individuals at the highest risk for endocarditis include those who already have an artificial heart valve, those born with certain heart defects and those who use intravenous drugs. Today there are guidelines established by the American heart association to help prevent endocarditis.
Prior to any surgery or certain dental procedures antibiotics may have to be taken to prevent bacterial endocarditis.