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Infective Endocarditis

August 27, 2012  by: Dr. Simran Kaur  Points: 12   Category: Health  Earning $0.20   Views: 504

Infective endocarditis is an inflammatory disease of heart valve and endothelium of cardiac chamber. In it there occurs microbial infection of the heart valve or the endothelium of heart.

         

Infective endocarditis is an inflammatory disease of heart valve and endothelium of cardiac chamber. In it there occurs microbial infection of the heart valve or the endothelium of heart.

Types-

Infective endocarditis is of four types which are as follow-

1. Sub-acute endocarditis.

2. Acute endocarditis.

3. Post operative endocarditis.

4. Right sided endocarditis.


1. Sub-acute endocarditis-
Sub-acute endocarditis is caused by low virulence micro-organisms. It mostly affects damaged valves or at part of endothelium which is damaged by high pressure jet of blood. Causative organisms are Streptococcus milleri, Streptococcus bovis, Staphylococcus aureus. Other secondary sources of infection in body from where infection may spread to heart and cause infective endocarditis are periodontal infections, gastro-intestinal tract infections and last of all urinary tract infections.

In subacute endocarditis, there is ill health, weight loss, fatigue and loss of appetite. Fever is there along with splenomegaly and clubbing in fingers. Mitral regurgitation and tricuspid regurgitation may develop. There occurs rupture of valve cusps which cause acute left ventricular failure and pulmonary oedema.


2. Acute endocarditis-
Acute endocarditis is caused by highly virulent and invasive micro-organisms. It affects damaged valves as well as normal heart. Causative micro-organisms which cause acute endocarditis are Staphylococcus aureus, Candida, Streptococcus pneumoniae.

In it the valve destruction is greater and there is more abscess formation. There is severe febrile illness along with prominent and changing heart murmurs. Renal failure and cardiac failure occurs at a very fast rate in acute endocarditis with recurrent embolism.


3. Post-operative endocarditis-
Post-operative endocarditis is also known as prosthetic valve endocarditis. It usually occurs after cardiac surgery using prosthetic valve or other prosthetic materials. It presents with fever in a patient who has had cardiac valve surgery. Infective causative micro-organisms are Staphylococcus albus, Candida and Aspergillus.

4. Right-sided endocarditis-
Right sided endocarditis especially affects intravenous drug users. It especially affects right sided heart valves, especially tricuspid valve. Causative micro-organisms are Staphylococcus aureus or Candida.


Laboratory Investigations-

Laboratory investigations required for diagnosis of infective endocarditis are as follow-

1. Hb test.

2. TLC, DLC tests.

3. Peripheral blood smear test.

4. Urine test.

5. ESR and CRP tests.

6. Blood culture test.

7. Chest x-ray test.




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