Endocarditis infection

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Infectious endocarditis is a disease characterized by damage to the heart valves and severe inflammation of the endocardial lining of the heart. The endocardium, the third outer layer of the heart wall on the outside, surrounds the heart cavity. Infectious endocarditis is one of the most difficult and difficult to diagnose diseases. If not treated in time, it can cause serious complications, make the patient very ill, and even lead to disability.

Studies have shown that the primary type of infectious endocarditis occurs in patients without damaged heart valves, while the secondary type is more common in people with acquired and congenital heart defects. Infectious endocarditis can occur in people who have previously undergone heart surgery, who have received sepsis, urological, invasive diagnostic procedures, or who are undergoing frequent intravenous drug therapy, and in drug addicts.

In addition, in acute respiratory diseases, the presence of purulent foci in the oral cavity and operations performed in this area, surgery of the genitals or prolonged examination of these organs with the help of instruments, prolonged probe (catheter) examination can lead to infection and disease. possible.

Clinically, there are acute, semi-acute and chronic (recurrent) forms of the disease.

Infectious bacteria travel through the blood to the heart valves, where they stop and form a secondary source of infection. In and around the valves, germs accumulate in the arteries and form clusters, which develop as the disease progresses, breaking down the embolus and spreading through the bloodstream, resulting in septic shock. Thromboembolism, or abscess-purulent foci, can occur when emboli stop flowing through the bloodstream to various parts of the body. Infections in the heart valves can cause an overreaction to organs and tissues. In general, the development and progression of the disease causes dystrophic changes in the affected organs. In the final stages of development, infectious endocarditis can progress to organ failure (eg, cardiovascular, hepatic, splenic, and renal failure).

The stages of development of infectious endocarditis depend on the degree of damage to the body's organ system. If the cause of the disease is a virulent pathogenic infection, an acute course of endocarditis is observed. Patients tremble, sweat profusely, and have a very high body temperature. This can lead to damage to the heart and internal organs, worsening cardiovascular and respiratory failure within 1-2 months, liver, spleen and kidney failure, or thrombotic embolism in the blood vessels of the brain. In such cases, the patient's life is in danger.

The moderate to severe course of the disease is characterized by general weakness, fatigue, loss of appetite, weight loss, headache, sweating, and decreased ability to work. In about one-third of patients, infectious endocarditis can often develop into angina, whooping cough, purulent otitis, urinary tract infection, abortion, or postpartum. In some people, the disease begins with hemorrhagic symptoms (such as gastrointestinal or nasal bleeding), while in others it is accompanied by septic hepatitis, pulmonary abscess, and thromboembolic swelling of the jugular veins. In the early stages of the disease, the patient's skin may be pale, gray, and in the evening - "milky coffee".

Infectious endocarditis is characterized by damage to the walls of small blood vessels, which cause bruising on the eyelids, hard and soft palate, neck, chest, wrists, and palms of the hands and feet, and hemorrhage. Some patients develop joint pain, which means that they develop arthritis in their small or large joints. In general, the main symptom of infectious endocarditis is a heart attack, which is characterized by pain in the chest, similar to angina or myocardial infarction.

Symptoms of focal nephritis develop in the early stages of the disease, and glomerulonephritis in the late stages. The liver and spleen may also be enlarged. Even the patient has nervous system damage, meningoencephalitis and mood swings.

The early stages of infectious endocarditis begin differently in different patients. For example:

In the gradual onset of the disease, there are cases of relaxation, malaise, and pain in the head and joints. At this time, infectious endocarditis should be distinguished from certain diseases (such as rheumatism, aortic valve insufficiency, pericarditis, polyserositis, arthritis).
When endocarditis begins in a state similar to that of an acute infectious disease, the patient sweats profusely, trembles, and has a high body temperature. In this case, it is important to distinguish infectious endocarditis from infectious diseases such as influenza, sweating, malaria.
When the disease begins with a thromboembolic complication (usually in the brain, spleen, kidneys), it should not be confused with kidney stones.
Infectious endocarditis can be accompanied by symptoms of acute glomerulonephritis, systemic lupus erythematosus, malaria, brucellosis, traumatic aortitis, or a "hematologic mask" with anemia and enlarged spleen. In such cases, it is necessary to distinguish this disease from many other diseases of the circulatory system.
To diagnose infectious endocarditis, the patient undergoes ECG, ExoKG (preferably transthoracic ExoKG), chest X-ray, peripheral vascular dopplerography, 3-hour thermometry, general blood test, general urine test, bactericidal blood test and other biochemical tests.

Treatment depends on the cause of the disease. In the early stages of infectious endocarditis, long-term use of large amounts of antibiotics that are sensitive to the disease will cure the disease faster. Hormonal, nonsteroidal, diuretic, and general boosting medications can also be given to improve the patient’s immune system. If treatment with antibiotics does not work, heart valves can be surgically replaced with artificial ones.

Everyone should know that in order to prevent the disease, it is important for a patient with heart disease to be under constant medical supervision, early detection of foci of purulent infections in the mouth, nose and other areas, and early treatment.

Gulchehra JABBOROVA, cardiologist of the highest category.