Endocarditis is an inflammation of the inner layer of the heart, the endocardium (hence its name). It usually involves the valves of the heart. Other structures that may be involved are the interventricular septum, the chordae tendineae, the mural endocardium, or the surfaces of intracardiac devices. Endocarditis is characterized by lesions known as vegetation, which is a mass of platelets, fibrin, microcolonies of microorganisms, and few inflammatory cells. In the subacute form of infective endocarditis, the vegetation may also include a center of granulomatous tissue, which may fibrotic or calcify.
There are several ways to classify endocarditis. The simplest classification is based on the causes: infectious or non-infectious, depending on whether a microorganism is the source of the inflammation or not. However, the diagnosis of endocarditis is based on clinical aspects, investigations such as echocardiography and blood cultures that demonstrate the presence of microorganisms that cause endocarditis. Signs and symptoms include: fever, chills, sweating, malaise, weakness, anorexia, weight loss, splenomegaly, flu feeling, heart murmur, heart failure, anterior trunk petechiae, Janeway lesions, etc.
The examination for suspected infective endocarditis includes a detailed examination of the patient, a complete history taking, and especially careful cardiac auscultation, various blood tests are required, such as: ECG and cardiac ultrasound (echocardiography). The blood test helps to reveal the typical signs of inflammation (increased sedimentation rate of erythrocytes, leukocytes). Usually two or more separate blood cultures are drawn. Negative blood cultures, however, do not exclude the diagnosis of infective endocarditis. Echocardiography (through the anterior or transesophageal chest wall) plays a role decisive in the diagnosis by reliably establishing the presence of microbial vegetation and the degree of valve dysfunction that affects the pumping function of the heart.
Endocarditis can be treated through antibiotics, if your endocarditis is caused by bacteria; Your doctor will advise you to take these medications until your infection and inflammation clear up. It can also be cured through surgery: it can remove damaged heart valves and replace them with artificial valves. If you have a milder case, the damaged area of the valve can be removed and replaced with the material made by man or tissue animals.
