Are you at risk?
An infection can occur anywhere in your body. Most infections are minor and your body’s immune system is able to fight it off without a problem. Some infections can be very serious because of the part of the body they impact. One of these areas is your heart. What happens to your heart when it’s target of an infection? How do the germs get to your heart? Can the infection be treated?
When you have an infection in the inner lining of your heart chambers and valves (endocardium), it’s called endocarditis. While this can be caused by any infectious agent, bacteria are the most common culprits. Typically, the germs reach your heart by traveling through your bloodstream from somewhere else in your body. There are several things that can result in this happening. One example is anything that can cause your gums to bleed, such as brushing your teeth or having dental work done, because it allows germs easy access to your bloodstream. Other possibilities include having an infection elsewhere in your body, using catheters of any type for long periods of time, getting tattoos or body piercings where the needles aren’t clean or using intravenous (IV) illegal drugs. Endocarditis can occur in healthy people, but is more likely to appear in individuals who already have damaged heart valves, artificial heart valves, congenital heart defects, a history of endocarditis or a history of IV drug use.
Symptoms can develop slowly or suddenly and usually vary from person to person. Common symptoms include flu-like symptoms (fever and chills), fatigue, aching joints/muscles, shortness of breath, night sweats, chest pain (especially when breathing), swelling to feet/legs/abdomen and a new/changed heart murmur. Endocarditis can also cause other symptoms that are less common, such as unexplained weight loss, blood in your urine, tenderness in your spleen, Janeway lesions (red spots on the soles of your feet/palms of your hands), Osler’s nodes (red, tender spots under the skin of your fingers/toes) and petechiae (tiny purple/red spots on your skin, whites of your eyes or inside your mouth). Serious complications can result from endocarditis. These are often caused by clumps of bacteria and cell fragments, called vegetations, that grow on the lining of your heart as part of the infection breaking off and travel to somewhere else in your body. This can result in a stroke, seizure, paralysis, pulmonary embolism (clot in your lung), abscesses (a pocket of collected pus) forming throughout your body, kidney damage and enlarged spleen. You also might have damage to your heart that results in the formation of a murmur, your heart valves not functioning correctly or heart failure. Most of these complications are serious enough that you could end up dying. This is why seeking prompt treatment is crucial.
Most cases of endocarditis are treated with antibiotics. This needs to be done in a hospital because you’ll need high doses that must be given intravenously (IV). In order to find the best antibiotic to treat the organism that is causing your infection, the doctor will need to take blood cultures (which requires a blood sample to be taken from a vein in your arm) because this allows the organism to be identified. You’ll need to spend at least a couple weeks in the hospital to make sure that the antibiotics are effective. After this period has past, you should be over the worst of the symptoms and your doctor will talk with you about continuing IV antibiotic therapy at home for several weeks. This requires either going to your doctor’s office to receive the medication or a home health nurse visiting frequently to administer it. During this period, it’s essential to monitor your symptoms to make sure that your infection isn’t getting worse. This means that you inform your doctor if you’re experiencing any fever, chills, headaches, joint pain, shortness of breath or swelling to your legs/ankles/feet.
If the infection is severe enough that it damages your heart valves, you could have symptoms and complications for years. This can lead to you needing to have surgery to repair or replace a damaged heart valve. If you do need a replacement, the material used can be an artificial valve made from a cow, pig or human heart tissue, which is known as a biological tissue valve. The other option is a man-made valve, which is also known as a mechanical valve. Both types have pros and cons, so discussing with your doctor which would be best for you is key.
Since endocarditis is very serious, prevention is vital. One of the most important things is to maintain good oral health by brushing and flossing regularly. It’s also a good idea to have regular dental exams. Another key element is to avoid things that increase your risk of having an infection, such as getting tattoos or body piercings. If you have a cut or sore that isn’t healing properly or any skin infections, be sure to have a doctor look at them. Knowing the symptoms of endocarditis is helpful in that you’re more likely to seek treatment quicker if you have any of them, which decreases your chances of developing complications. If you’re at increased risk of developing endocarditis, it’s essential to talk to your healthcare provider or dentist prior to having any procedures done. They might recommend using antibiotics beforehand as a way to reduce your chances of getting endocarditis. Another important thing to consider if you have an elevated risk, is to carry an endocarditis wallet card with you at all times because this will inform healthcare personnel of this risk in the event that you’re unable to. These cards are available through the American Heart Association.
While endocarditis is rare, it isn’t something that you want to take a wait and see approach when deciding if you need to seek treatment. The earlier you get help the better. If you have any questions or concerns about endocarditis, please speak with your doctor. If you would like more information, please visit the American Heart Association’s Endocarditis page at https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-problems-and-causes/heart-valves-and-infective-endocarditis