Endocarditis test

Endocarditis is a potentially fatal inflammation of the inner lining of the chambers and valves of the heart. This covering is known as the endocardium.

Endocarditis is typically the result of an infection. In the heart, bacteria, fungi, and other pathogens enter the bloodstream and attach to damaged areas. Artificial heart valves, damaged heart valves, and other heart defects increase the likelihood of contracting endocarditis.

Endocarditis has the potential to damage or destroy the heart valves if not treated promptly. Endocarditis is treated with medication and surgery.

Endocarditis Types

There are two primary forms of tricuspid valve disease that induce incorrect valve function:

  • When the flaps of the tricuspid valve become thick, rigid, or joined, tricuspid valve stenosis occurs. This results in a decreased blood flow between the atrium and ventricle and a constricted valve opening.
  • Tricuspid valve regurgitation occurs when the tricuspid valve does not seal tightly, allowing blood to flow backward into the right atrium. The most prevalent cause of regurgitation is a prolapsing valve, in which the valve flaps bulge back into the right atrium when the heart contracts.


Endocarditis Symptoms

The following are frequent endocarditis symptoms:

  • Joint and muscle aches
  • Breathing causes chest pain
  • Flu-like symptoms, including fever and shivering
  • Sweats at night
  • Shortness of breath
  • Swollen feet, legs, or abdominal organs
  • Altered whooshing sound in the heart   (murmur)

Endocarditis Causes

Endocarditis is typically caused by a bacterial, fungal, or other microbial infection. The pathogens enter the circulatory system and go to the heart. They adhere to broken heart valves or damaged cardiac tissue in the heart.

Typically, the immune system eliminates any pathogenic bacteria that enter the bloodstream. Under the correct conditions, germs on the skin or in the mouth, throat, or intestines can enter the bloodstream and cause endocarditis.

Among the risk factors for endocarditis are:

  • Older age. Endocarditis is more prevalent in persons over the age of 60.
  • Artificial heart valves. Artificial (prosthetic) heart valves are more susceptible to microbial attachment than natural heart valves.
  • Damaged heart valves. Certain medical diseases, such as rheumatic fever or infection, can damage or scar one or more heart valves, hence increasing the likelihood of infection. A previous e ndocarditis also raises infection risk.
  • Congenital heart conditions. Certain types of congenital heart defects, such as an irregular heart or damaged heart valves, increase the likelihood of heart infections.
  • Implantable heart device. By attaching to an implanted device, such as a pacemaker, bacteria can cause an infection of the heart’s lining.
  • Injectable narcotics use. Infections such as endocarditis may result from the use of contaminated injection needles. The use of contaminated needles and syringes is a particular problem for illicit drug users, such as heroin and cocaine.
  • Poor dental health. Oral and periodontal health are vital for optimal health. If you don’t frequently brush and floss, bacteria can form in your mouth and enter your bloodstream through a cut on your gums. Some gum-cutting dental treatments may also cause microorganisms to enter the bloodstream.
  • Long-term catheterization. A catheter is a narrow tube employed for medical treatments. Long-term catheter placement increases the chance of developing endocarditis.

Endocarditis Complications

In endocarditis, a mass of irregular, germ- and cell-based growths forms within the heart. These are referred to as vegetations. They are capable of escaping and traveling to the brain, lungs, kidneys, and other organs. Additionally, they can travel to the limbs.

Endocarditis may cause the following complications:

  • Heart failure
  • Valve damage
  • Pockets of pus that form in the heart, brain, lungs, and other organs.
  • Blood clot in a lung artery (pulmonary embolism)
  • Kidney disease
  • Spleen enlargement
  • Stroke

Endocarditis Diagnostics

Endocarditis diagnostic tests include:

  • Blood cultures that reveal bacteria or microorganisms that are commonly found in patients with endocarditis.
  • Blood cultures, which are repeated blood tests, enable a laboratory to isolate the specific bacteria that are causing your infection. Before you start taking antibiotics, the lab must take blood cultures to confirm the diagnosis.
    A complete blood count can tell your doctor if you have an abnormally high number of white blood cells. This could indicate that you have an infection.
    Inflammation can be detected through blood tests for substances such as C-reactive protein.
  • Echocardiogram (heart ultrasound) may reveal growths (vegetations on your valve), abscesses (holes), new regurgitation (leaking) or stenosis (narrowing), or an artificial heart valve that has started to pull away from your heart tissue. To get a closer, more detailed look at your heart, providers may insert an ultrasound probe into your esophagus (transesophageal echo).
  • Examining heart valve tissue to determine the type of microbe present.
  • PET or nuclear medicine scans use radioactive material to create images that can show the location of an infection.

Endocarditis Treatment

Antibiotics are effective in treating many people with endocarditis. Surgery may be required in some cases to repair or replace damaged heart valves and to remove any remaining signs of infection.

The type of medication you receive is determined by the cause of your endocarditis.

Bacterial endocarditis is treated with high doses of IV antibiotics. If you are given IV antibiotics, you will usually be hospitalized for a week or more so that doctors can determine if the treatment is effective.

You may be able to leave the hospital once your fever and any severe symptoms have subsided. Some people continue IV antibiotics with office visits or at home with home care. Antibiotics are typically taken for a period of several weeks.

Antifungal medication is given if endocarditis is caused by a fungal infection. Some people require antifungal pills for the rest of their lives to prevent endocarditis from recurring.

Surgery or other medical procedures
To treat persistent endocarditis infections or to replace a damaged valve, heart valve surgery may be required. Surgery may be required to treat endocarditis caused by a fungal infection.

Depending on your specific condition, your doctor may advise you to repair or replace your heart valve. A mechanical valve or a valve made from cow, pig, or human heart tissue is used for heart valve replacement (biologic tissue valve).