Infective endocarditis is a lesion of the heart valves and endocardium. It is caused by bacteria. As a rule, these are streptococci. But sometimes mushrooms are the causative agents.
Etiology and pathogenesis
Most often, pathogens get to the heart chambers along with the bloodstream. However, there are cases when infective endocarditis becomes ill due to the fact that the infection is introduced during open heart surgery. Microbes settle on the valves and infect the endocardium. Tissues with anatomical defects or damage are most susceptible to infection. However, normal heart valves are also affected by certain types of microorganisms, especially against the background of a general decrease in immunity. It happens that colonies of bacteria and accumulations of blood clots are destroyed and enter other organs with the bloodstream. They can infect them or cause blockages in the arteries. Because of this, the patient may begin an inflammatory process in the area of accumulation of pathogens, have a heart attack or stroke.
Infective endocarditis: classification
Thisthe disease is acute and subacute. Acute infective endocarditis is a disease that begins suddenly (up to several days) and poses a threat to life. The temperature of the human body rises to 40 ° C, the frequency of heart contractions increases greatly, fatigue rapidly increases, and extensive valve damage is observed. Emboli (endocardial vegetations) break off from it, which are carried by the bloodstream throughout the body, entering other organs, which can cause their inflammation and blockage of important vessels. Within a few days, severe heart failure, shock, septic syndrome with failure of internal organs may develop. Arteries weakened by inflammation can rupture. With this form of the disease, a fatal outcome is possible.
Subacute infective endocarditis is a disease that develops gradually. Its imperceptible course can last from several weeks to several months. Without a special examination, only severe valvular damage or embolism allows the diagnosis of endocarditis. If the course is not expressed, the symptoms may be as follows: a slight increase in temperature (usually no more than 38 ° C), constantly increased sweating, weight loss, anemia, high fatigue.
It is possible to suspect that a person is sick with infective endocarditis if he has a temperature for a long time without an obvious source of infection, inflammation; existing heart murmurs appear or change; the spleen enlarges. Often on the skin of a person there are smallspots resembling freckles. They can appear under the nails and on the whites of the eyes. These are small hemorrhages, which are provoked by the entry of detached embolisms into small vessels. Larger blood clots can block large arteries in the arms or legs, cause abdominal pain, stroke, or heart attack. Ways to treat diseases - antibiotic therapy, surgery (if necessary, remove bacterial vegetations or replace valves).
Secondary endocarditis
The disease can develop again after a previous illness or for the first time against the background of existing ailments (defects and anomalies of the heart, atherosclerosis, rheumatism, etc.). This pathology is called "secondary infective endocarditis".
