DEFINITIONS
Infective endocarditis is an infection of endokardium (pericardium) and heart valves.
Bacteria that cause acute bacterial endocarditis is sometimes strong enough to infect normal heart valves; bacteria that cause subacute bacterial endocarditis is almost always infect the abnormal valves or valve damage.
CAUSE
Bacteria (or fungi) found in the bloodstream or that pollute the heart during heart surgery, can get stuck in and infect the heart valves endokardium.
The most susceptible to infection is an abnormal valve or valves are damaged, but normalpun valve can become infected by bacteria that aggressive, especially if their number is many.
Heaps of bacteria and blood clots on the valve (vegetation) can be detached and moved to the vital organs, where they cause the blockage of arterial blood flow.
Such blockage is very serious, because it can cause strokes, heart attacks and infections, as well as areas where the formation of damaging clots.
Risk factors of infective endocarditis:
- Damage to the skin, the lining of the mouth or gums (due to chewing or brushing your teeth), which allows entry of small amounts of bacteria into the bloodstream
Gingivitis (infection and inflammation of the gums), a small infection on the skin and infections in other body parts, can serve as the entrance of bacteria into the bloodstream.
- A particular surgery, dental procedures and some medical procedures can also facilitate the bacteria to enter the bloodstream.
An example is the use of intravenous infusion to include fluids, food or medicines; sitoskopi (insert tube to examine the bladder) and colonoscopy (insert tube to examine the large intestine).
- Heart valves have been damaged
In people with normal heart valves, white blood cells in the body will destroy these bacteria. But the heart valves have been damaged can cause bacteria and multiply stuck there.
- Artificial heart valves
On artificial heart valves, the bacteria can enter and bacteria more resistant to antibiotics.
- Congenital abnormality or abnormalities that allow the leakage of blood from one part of the heart to other parts of the heart
- Septicemia
Bacteremia (bacteria in the blood) that its light may not cause immediate symptoms, but bacteremia may develop into septicemia.
Septicemia is a severe infection in the blood, which often causes high fever, chills, shivering and decreased blood pressure.
- Users injecting drugs, because they often use a needle or a dirty solution.
In injecting drug users and people with endocarditis due to prolonged use of catheters, which are often infected valve is the valve that leads to the right ventricle (trikuspidalis valve).
In most other cases, the infected valve leading into the left ventricle (mitralis valve) or a valve that came out of the left ventricle (aortic valve).
In artificial valve users, the greatest risk of endocarditis is for 1 year after surgery, after which the risk is reduced, but remained higher than normal.
For reasons unknown, the risk is always higher in artificial aortic valve compared with artificial mitral valve, and the risk of mechanical valve higher than the pig valve.
SYMPTOMS
Acute bacterial endocarditis usually begins suddenly with high fever (38,9-40,9? Celsius), rapid heartbeat, fatigue and heart valve damage fast and wide.
Vegetation endokardial (emboli) which can move apart and cause infection elsewhere additional
Accumulation of pus (abscess) may occur at the base of the infected heart valve or in a place tersangkutnya infected emboli.
Heart valves may have perforations (perlubangan) and within a few days could be a big leak.
Some patients experienced shock; kidneys and other organs stopped functioning (sepsis syndrome).
The infection can weaken the arterial blood vessel wall and led to rupture of blood vessels.
This rupture can be fatal, especially when the brain occurs at or near the heart.
Subacute bacterial endocarditis can cause symptoms several months before the damaged heart valves or prior to the formation of emboli.
The symptoms of fatigue, mild fever (37,2-39,2? Celsius), weight loss, sweating, and anemia.
Suspected endocarditis if a person has a fever without a clear source of infection, if found a new heart murmur or if the murmur of the old has undergone a change.
Can be enlarged spleen.
Bint arise on the skin, a very small dots, also in the whites of the eyes or under the fingernails.
These spots are very small bleeding caused by small emboli out of the heart valves.
Larger emboli can cause abdominal pain, a sudden blockage in the arm or leg arteries, heart attack or stroke.
Other symptoms of acute bacterial endocarditis and subacute are:
- Chills
- Painful joints
- Pale skin
- Rapid heartbeat
- Confusion
- The existence of blood in the urine.
Endocarditis on an artificial heart valve can be either acute or subacute.
Compared with infection of native valves, infection of the artificial valve is more easily spread to the heart muscle at the base of the valve and loosen the valve. Need immediate surgery to replace the valve because of heart failure caused by severe valve leakage can be fatal.
Or it could be an interruption in the electrical conduction system of the heart that resulted in slowing heart rate and cause a sudden decrease in consciousness or even death.
Diagnosis
Diagnosis based on symptoms, especially in people who have a tendency to suffer from this disease.
On echocardiography (cardiac representations using sound waves) can be found in the vegetation and damage the heart valves.
Blood culture done to determine the bacterial cause.
Blood tests carried out 3-4 times at different times, because the bacteria is only found in the blood at certain times.
TREATMENT
Patients treated at the hospital and get a high dose of intravenous antibiotics for at least 2 weeks.
Antibiotics alone are not enough on artificial valve infection.
May need heart surgery to repair or replace the damaged valve and remove vegetation.
As a precautionary measure, to people with heart valve disorders, each will undergo dental or surgical measures should be given antibiotics.
No Response to "Infective endocarditis"
Post a Comment