There is a disease that consists of infection of the inner lining of the chambers and valves of the heart, called endocarditis. Although it is rare, it can be life-threatening and have serious complications as it affects the structure and functioning of the heart, but if diagnosed early, it can be cured without sequelae. For this reason, it is essential to know who is at risk, how to suspect it to request early medical attention, and most importantly, how to prevent it.
Factors riesgo
The infection is caused by germs (bacteria, fungi...) normally present on the skin, mouth, genitourinary or digestive system; that can enter the bloodstream, travel to the heart, and once there, adhere to tissues, especially when they are abnormal or artificial. It is less common to happen in normal hearts, but it is still a possibility if there are factors that favor the entry of germs into the blood or a weakness of the immune system. Taking the above into account, the factors that favor endocarditis are:
- Have more than 60 years.
- Wear artificial heart valves. The so-called prostheses are more susceptible to germs affecting them
- Have damaged heart valves. History of past diseases such as rheumatic fever, endocarditis; or valves with strictures or insufficiencies that have required surgery
- Congenital heart defects (bicuspid valve)
- Implanted cardiac device (pacemaker, defibrillators).
- Consumption of illegal intravenous substances. Repeated injections without adequate sterilization encourage bacteria from the skin to enter the blood.
- Poor dental hygiene. Bacteria that grow in the mouth can enter the bloodstream through a cut in the gums, such as those made in some dental procedures or those that can happen if the tissue is in poor condition.
- Use of indwelling catheter. There are people who have long-term venous catheters to administer medication for other diseases. Being in place for a long time and having contact with the skin increases the risk of endocarditis.
Symptom
The symptoms of endocarditis can vary from person to person. It can develop slowly or suddenly depending on the type of germ causing the infection and whether or not there are other heart problems. If not treated immediately, endocarditis can damage or destroy the heart valves. It requires treatment with intravenous antibiotics for very long periods or, in selected cases, cardiac surgery. If you have risk factors for the disease and develop the following symptoms, you should see your doctor as soon as possible.
- A new breath in the heart
- Flu-like symptoms, such as fever, chills, and muscle/joint pain, but that last more than 10 days or do not improve with regular pain relievers
- Chest pain when breathing
- Night sweats
- Shortness of breath
- Swelling in the feet, legs, or abdomen
- Weight loss without apparent cause
- Red, purple, or brown spots or bumps on the soles of your feet or palms of your hands
- Small bleeding under the nails
- Small round spots on the skin, flat and that do not lose color when pressed (Petechiae).
Prevention
We must know well the risk factors that make us vulnerable in order to take measures to reduce the entry of germs into the blood.
- Learn to identify the possible signs and symptoms of endocarditis. Consulting a doctor and making an early diagnosis can avoid serious complications.
- Good dental hygiene. Brushing, flossing, and having regular dental exams prevents bacterial overgrowth or lesions in the mouth.
- Keep skin healthy. Cleanse the skin regularly. Wash your wounds and keep them clean until they heal. If you have tattoos, piercings or cosmetic procedures, do so in trusted places with adequate hygiene.
- Do not consume illicit intravenous drugs. Dirty needles or frequent punctures increase the risk of endocarditis
- Preventive antibiotics. Certain medical procedures in areas such as the skin, the digestive or genitourinary system, as well as dental procedures, can allow bacteria to enter the bloodstream. If you have any type of heart condition that predisposes you to endocarditis, talk to your cardiologist, dentist, and other medical specialists about the risks and ask if you need antibiotic prophylaxis. Prophylaxis usually consists of taking a single antibiotic 30-60 minutes before the procedure.
By Dr. Laura Espinosa, specialist at UICAR
Endocarditis affects the heart valves: its follow-up is the responsibility of the Valvular Heart Disease Unit of UICAR.