Brief description of the disease
Endocarditis - inflammation formed in the inner shell of the heart during an infection, fungal diseases, sepsis, diffuse connective tissue lesions, poisoning (uremia).
By origin distinguish rheumatoid and infection, or bacterial endocarditis.
Infective endocarditis occurs most often due to streptococcus, E. coli and Pseudomonas aeruginosa, Staphylococcus, Proteus and other pathological microorganisms.
There are also cases of endocarditis due to congenital, acquired heart disease, prosthetic valve after installation, but it happens rarely.
Rheumatic endocarditis develops as a complication of rheumatic heart available.
The risk of endocarditis is also increased in those who had already suffered the disease, hypertrophic cardiomyopathy is suffering, sick with AIDS, is on dialysis, using drugs (provocation: manipulation of the vein under aseptic conditions).
Symptoms of endocarditis
Symptoms of endocarditis, which developed due to infection, appear for the first 2 weeks after infection. Characterized feeling like the flu: fatigue and low-grade fever. If the infection occurred potent strains can be observed more severe symptoms of endocarditis. This may be fever and chills, weight reduction, pain in the joints, excessive sweating at night, shortness of breath and persistent cough, bleeding under the nails, petechiae (small red or purple spots on the skin).
If infective endocarditis caused valvular may develop symptoms of heart defects, if the heart muscle is inflamed, you may experience an arrhythmia, heart failure, impairment of conduction. If the inflammation of blood vessels participate begins thrombosis, myocardial spleen or liver, may appear aneurysm, bruising of the skin. It can also be found glomerulonephritis, increase in liver, spleen, slight jaundice.
Symptoms of endocarditis, which developed because of rheumatic fever: mild malaise, chills, fever, pain in the heart, shortness of breath, palpitations, even at low load, increased heart rate, abnormally excited activity of the heart, the shift of its borders. When listening to the heart observed systolic or diastolic noises. It accelerates the reaction of erythrocyte sedimentation.
Complications that can develop after endocarditis: a break valves, impaired renal function, heart disease. Also, there is a decrease the level of white blood cells, hemoglobin, increased erythrocyte sedimentation rate.
Diagnosis of the disease
Diagnosis helps echocardiographic examination - as revealed damage to the valves, the localization and the extent of proliferation of bacterial colonies. If infective endocarditis to identify the pathogen, to determine the level of sensitivity to antibiotics, do blood cultures.
Treatment of endocarditis
Treatment of endocarditis is an antibiotic (in high doses), immunotherapy (antistafilakokkovy administered gamma globulin and plasma). Patients also appoint immunomodulators (timalin, T-activin), glucocorticosteroid hormones (eg, prednisone), kuraltil, aspirin, trental heparin.
Also, the positive effect is endocarditis treated by ultraviolet irradiation of blood, holding hemosorption, plasmapheresis.
For the treatment of bacterial endocarditis can assign the sodium salt of benzylpenicillin at high doses of drugs or penicillin group (methicillin, oxacillin), or cephalosporins, gentamicin.
If an antibiotic to eliminate the endocarditis is not removed, may designate an operation to remove and replace the affected valve.
Timely conduct of drug therapy can achieve sustained remission (in some cases 3-5l), but the patients are unable to work. Relapses of bacterial endocarditis can cause severe damage to the valves and heart failure. A high probability of death in cases of complications of endocarditis, chronic renal failure.
Treatment endocarditis caused by rheumatism is the same as the underlying disease: assigning salicylic sodium (aspirin, aminopyrine), phenylbutazone, indomethacin, prednisolone, or prednisone. They may also appoint penicillin. Patients showed a fractional power, limiting the amount of salt intake, intake of vitamin B.
Prevention of disease
Infective endocarditis can be prevented only effective treatment for infections and sepsis, especially in patients with acquired or congenital heart defects.
Prevention of rheumatic endocarditis is to prevent rheumatic fever and its timely and proper treatment, the maintenance of immunity.