Infective endocarditis is a rare but potentially serious disease that affects the inner lining of the heart and its valves. Therefore, preventing infective endocarditis is crucial: although uncommon, it can lead to severe complications such as valve damage, heart failure , cardiogenic shock, and even death.
And the good news is that many of the preventative measures are within everyone's reach.
What is infective endocarditis?
Infective endocarditis occurs when bacteria or other microorganisms enter the bloodstream and attach to the heart, especially the heart valves.
Its treatment is usually complex and requires specialized medical attention, so prevention is always the best strategy.
Who is at greatest risk?
Not everyone is at the same level of risk, although we should all be aware of this disease and how to prevent it.
High-risk patients
People most likely to develop infective endocarditis are:
- Patients with a history of previous endocarditis.
- People with prosthetic heart valves or surgical/percutaneous valve implants.
- Patients with congenital heart disease.
- People with ventricular assist devices.
Patients at moderate risk
There is also a group with intermediate risk:
- Rheumatic heart disease.
- Non-rheumatic degenerative valvular disease.
- Congenital valvular abnormalities, including bicuspid aortic valve.
- Patients with pacemakers or implantable cardioverter defibrillators (ICDs).
- Hypertrophic cardiomyopathy.
Risk situations and procedures
Some procedures can facilitate the entry of bacteria into the bloodstream.
1. Dental procedures
These are the ones most frequently associated with the risk of endocarditis, especially:
- Dental extractions.
- Oral and periodontal surgery.
- Dental implant placement.
- Oral biopsies.
- Deep cleanings and root canal treatments.
2. Non-dental procedures
Some invasive procedures may also pose a risk:
- Respiratory system.
- Gastrointestinal tract.
- Genitourinary system.
- Skin and soft tissues.
- Musculoskeletal system.
3. Cardiac or vascular interventions
Invasive cardiac interventions also require individualized preventive assessment.
Prevention measures for everyone
Many of the recommendations are simple and effective for the general population.
Maintain good oral hygiene
Oral health is one of the main prevention tools:
- Brush your teeth at least twice a day.
- Use dental floss.
- Have regular dental checkups.
Caring for skin and wounds
- Properly clean and disinfect cuts or wounds.
- Consult a doctor if you experience any signs of infection.
Avoid self-medication
The incorrect use of antibiotics promotes bacterial resistance and does not adequately prevent disease.
Avoid risky practices
- Tattoos or piercings in places without sanitary control.
- Invasive procedures without adequate hygiene measures.
These actions help to reduce the entry of bacteria into the bloodstream, the main mechanism for the development of the disease.
Are antibiotics needed before certain procedures?
Currently, scientific evidence indicates that antibiotic prophylaxis is NOT necessary for most people.
Its use is primarily reserved for high-risk patients who will undergo invasive dental procedures.
In these cases, preventive treatment is usually administered between 30 and 60 minutes before the procedure, using antibiotics such as:
- Amoxicillin
- Ampicillin
- Cephalexin
- Azithromycin (in patients allergic to penicillins)
In patients at moderate risk or in high-risk individuals undergoing non-dental procedures, the indication will depend on individual medical judgment.
This approach represents a significant change: today, daily prevention and comprehensive care are prioritized over the indiscriminate use of antibiotics.
A final message to take care of your heart
Preventing infective endocarditis doesn't depend solely on complex medical treatments. It often begins with simple daily habits:
- Maintain proper oral hygiene.
- Take care of your overall health.
- Consult a doctor if you experience any signs of infection.
- Have regular medical check-ups.
If you have heart disease or are unsure about your risk, consult your doctor for personalized recommendations.
Taking care of the everyday also protects your heart.
By Dr. Matías Oliva, cardiologist at the La Luz University Hospital.