Infective endocarditis: Infective endocarditis is an infective process involving the inner layer of the heart (endocardium). The most important structures involved in infective endocarditis are the valves of the heart as the valves are derived from the endocardium.

What is the most common symptom of infective endocarditis?

Prolonged fever is the most common symptoms of infective endocarditis, though rarely fever may not be very prominent. If prolonged fever occurs in any person known to have disease of heart valves, infective endocarditis has to be ruled out by good physical examination and appropriate tests.

Can infective endocarditis occur in persons without preexisting valvular heart disease?

Though most often infection occurs on a previously damaged valve or an artificial valve, rarely normal valves also can get infected. This can occur in those persons whose body resistance has come down due to certain other illnesses. It is also noted in some main line (intravenous) drug abusers. While left sided valves are more often involved in the usual population, right sided valves are more affected with drug abuse.

What are the other symptoms which can occur in infective endocarditis?

Since it occurs commonly in those with preexisting heart disease, there is usually a worsening of symptoms like breathlessness. This is due to increase in the damage to the valves with infection. Sudden severe breathlessness may occur if there a perforation of the valve leaflet producing severe leak. Infective material may move through blood circulation and get lodged in other parts of the body (septic emboli). These can produce local collections of pus with damage to the organ where it is lodged. It can occlude a blood vessel and sometimes cause paralysis by damaging part of the brain. If the electrical system of the heart is affected, heart rate may fall and giddiness occur. Multiple reddish spot may appear in the skin where the infective material gets lodged. These can be painful as well. If the kidneys are damaged in a similar process, urine output goes down and puffiness of face with swelling of ankles may develop.

Can infective endocarditis be treated?

Infective endocarditis needs a prolonged course of appropriate antibiotic therapy if the cause is bacterial infection. Sometimes it can be due to fungal infection this would need anti fungal medication. Fungal endocarditis and endocarditis involving artificial valves are particularly difficult to treat. Sometimes surgical removal of the valve and replacement with a biological prosthetic (artificial) valve is needed, to tide over the crisis.

Can you prevent infective endocarditis?

Good personal hygiene is of utmost importance in infective endocarditis if you have a valvular heart disease. Good dental hygiene is mandatory. Any dental procedure or surgical procedure carries a small but real risk of infection spreading through the blood stream. The need for preventive antibiotics for the procedure is to be decided by your physician depending on your individualized risk as per published guidelines, which may be modified from time to time. Those with artificial valves, previous history of endocarditis and those with complex birth defects of the heart are having the highest risk in this respect.