Endocarditis is inflammation, with or without infection, that affects the inside lining of the heart and heart valves.
Bacteria or fungi are the usual cause. Bacteria include Staphylococcus and Streptococcus. The bacteria or fungi can get to the heart by entering the bloodstream from infections somewhere else in the body (e.g., urinary or gastrointestinal tract or skin). Surgical or dental procedures can also let these organisms reach the heart.
Symptoms include fever, fatigue, weakness, chills and night sweats, muscle and joint pain, and heart murmur. Later symptoms are swelling of feet and legs and shortness of breath with an irregular heartbeat.
The health care provider can make a diagnosis by taking a medical history, doing a physical examination, and getting blood cultures and an echocardiogram (ultrasound of the heart). The health care provider usually finds a new heart murmur due to the damaged heart valve at the physical.
Intravenous antibiotics, usually given for 4 to 6 weeks, are used to get rid of the infection. A home health nurse will help with intravenous antibiotic treatment at home. Nonaspirin medications such as acetaminophen can be used for fever and minor pain. A regular diet can be followed. Fluid intake should be increased for fever. Good dental hygiene is needed to prevent infection.
Another goal is to treat complications (e.g., congestive heart failure or blood clots). The health care provider may suggest surgery in some cases. Surgery may be needed for congestive heart failure that doesn’t respond to usual therapy, endocarditis caused by fungi, recurrent blood clots, abscesses leading to heart rhythm abnormalities, and lasting high fever or sepsis after 72 hours of antibiotics.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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