At Compass Community Health Care Center we are dedicated to providing the best health care possible. We are listening to our patients, families, and community with their health concerns and questions. Watch for #LiveWellWednesday posts each Wednesday evening, which focus on giving you the information and tips you need to understand current health care concerns and topics.
Today’s topic is Endocarditis, by Paul (PJ) Adkins, Compass Community Health Care Center Family Nurse Practitioner.
In honor of February being Heart Health Month, we will be highlighting heart health issues and topics all this month during our #LiveWellWednesday posts. Be sure to check back each Wednesday in February for more information from Compass Community Health Care Center Family Nurse Practitioner, Paul Adkins.
Today’s article is about bacterial endocarditis which is an infection of the heart’s endocardial surface and typically involves an infected heart valve. Infection or vegetation on more than one of the valves can sometimes occur as well. A fever is the most common patient symptom. Some other common symptoms include chills, night sweats, cough, pleuritic chest pain, shortness of breath, malaise, headache, joint pain, and weight loss. A murmur is often heard in patients with endocarditis as well. Two common risk factors for endocarditis are untreated dental abscesses and intravenous drug use. Patients who are immunosuppressed and patients with indwelling central venous catheters are at an increased risk for endocarditis too. Patients with prosthetic joint replacements and those with valve replacements are also at an increased risk. Many patients with predisposed risk factors like joint replacements and moderate murmurs may need to take antibiotics prophylactically prior to having dental work done.
Endocarditis is an infection that can result in other problems like valvular insufficiency, heart failure, stroke, sepsis, septic emboli, and other infections throughout the body. Staphylococcus and streptococcus organisms are two common bugs that can cause endocarditis. However, other atypical organisms can lead to infection of the heart’s endocardial surface as well. Lab findings consistent with endocarditis can often include an elevated white blood count, an elevated sedimentation rate, an elevated C reactive protein, anemia and positive blood cultures. EKGs can reveal heart block or conduction delays with endocarditis. Chest xrays can help rule out heart failure. Surface echocardiograms are often the first test that clearly identifies that endocarditis exists by allowing visualization of the heart valves. A transesophageal echocardiogram (TEE) is often done if there are suspicious findings on a regular surface echo because a TEE can allow for better visualization of the heart valves. In some cases, cardiac MRI is even performed for better visualization of the heart. The aortic valve and mitral valve are routinely the most common valves that are involved, but the pulmonic and bicuspid valves can sometimes become infected.
The mainstay treatment for bacterial endocarditis is long term intravenous antibiotic therapy. Six weeks of antibiotics through a PICC line is often recommended and follow up with an infectious disease physician and cardiologist is incorporated in the plan of care. A repeat TTE, blood cultures, and blood work will often be performed after the antibiotic course has been completed. Patients with complicated infections who do not improve or worsen clinically may end up needing valve replacement surgery. Patients who develop sepsis and become critically ill from bacterial endocarditis can develop multi-system organ failure and even die. Valvular disorders can remain years after the infection resolves in some patients along with long standing heart failure.
Patients should seek medical care right away if they have had a fever that lasts many days or if they have developed any of the symptoms mentioned above. Prevention of endocarditis should involve routine dental checkups, avoiding intravenous drug use, seeking care for any signs of infection, and routine health maintenance with well checkups. Take good care of your heart and maintain a healthy lifestyle. Prevention and maintenance can go a long way in helping you stay healthy and potentially avoid heart problems.
For additional information on this topic check out the American Heart Association at www.heart.org or to schedule an appointment with one of our providers, please contact our office 740-355-7102.