endocarditis

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endocarditis

(ĕn'dōkärdī`tĭs), bacterial or fungal infection of the endocardium (inner lining of the heart) that can be either acute or subacute. In the acute form the symptoms (fever, malaise, fatigue, weight loss, anemia) are directly related to the presence of an active infection that runs its course within a few weeks. Acute endocarditis may follow respiratory infection, surgery, or other trauma; but in some cases the source of infection is unknown. A major cause of endocarditis is the use of contaminated intravenous needles by drug addicts. Bacterial endocarditis is an insidious, often progressive, disease that can lead to kidney failure and congestive heart failure. The causative agent in many cases of subacute disease is Streptococcus viridans. Endocarditis is often a complication of Lyme disease. A previously damaged valve increases the risk of infection tenfold. The most common diseases causing these predisposing valvular deformities are rheumatic feverrheumatic fever
, systemic inflammatory disease, extremely variable in its manifestation, severity, duration, and aftereffects. It is frequently followed by serious heart disease, especially when there are repeated attacks. Rheumatic fever usually affects children.
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 and congenital heart diseasecongenital heart disease,
any defect in the heart present at birth. There is evidence that some congenital heart defects are inherited, but the cause of most cases is unknown.
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. Thrombi associated with the infection on the valve often dislodge and spread septic emboli throughout the body that may damage the kidney. Primary diagnostic symptoms are fever and a changing heart murmur. Physical diagnosis can be confirmed by the use of echocardiography (ultrasoundultrasound
or sonography,
in medicine, technique that uses sound waves to study and treat hard-to-reach body areas. In scanning with ultrasound, high-frequency sound waves are transmitted to the area of interest and the returning echoes recorded (for more detail, see
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). Treatment with high doses of antibiotics often kills the bacteria, but the damage to the valve may put an additional strain on the heart that can eventually lead to cardiac failure. However, it is sometimes possible through follow-up corrective surgery to repair or replace valves damaged by endocarditis.

Endocarditis

 

inflammation of the inner membrane, or endocardium, of the heart. Endocarditis is caused chiefly by rheumatism and sepsis. It occurs occasionally in myocardial infarction, uremia, syphilis, tuberculosis, and other diseases. The disease is usually combined with myocarditis; less commonly it occurs with pericarditis. Valvular insufficiency occurs when mostly the endocardium of the heart valves is affected.

Subacute septic, or malignant, endocarditis is caused by Streptococcus viridans or, less often, by staphylococcal or other bacteria. Change in the body’s immunity is significant. Because penetration by microbes is facilitated by injury to the endocardium and by congenital structural defects of the heart, septic endocarditis can be “superposed” on rheumatic and congenital heart disease. The necrotic and ulcerative changes that take place in the endocardium often result in arterial embolism in the systemic circulation. Inflammatory and degenerative changes and hypersensitivity vasculitis arise in the myocardium, and capillary permeability increases. The disease is manifested by fever, chills, weakness, and pain in the joints and bones. Petechial hemorrhages appear on the mucous membranes and on the skin, which acquires a greenish brown color. The terminal phalanges of the fingers thicken, causing the fingers to look like drumsticks and the nails like watch glasses. Signs of valvular disease (generally incompetence of the aortic valve) and anemia appear, and the spleen and liver become enlarged. Hemorrhagic pleurisy, focal glomerulonephritis, and other diseases may develop. The causative agent of the disease can often be isolated from the blood.

Acute septic endocarditis is less common than the subacute form. It is usually caused by hemolytic streptococcus entering the blood from the primary septic focus. The disease has similar symptoms, but its course is more severe than that of acute septic endocarditis. Endocarditis is treated mainly by prolonged administration of fairly large doses of antibiotics. Prevention requires clinical follow-up of patients with rheumatic and congenital heart diseases, elimination of focuses of infection in the body, and hardening of the body.

REFERENCE

Teodori, M. I. Zatiazhnoi septicheskii endokardit. Moscow, 1965.

N. R. PALEEV and S. D. KAPANADZE

endocarditis

[¦en·do·kär′dīd·əs]
(medicine)
Inflammation of the endocardium.
References in periodicals archive ?
Specifically, they are developing an EHR order set to remind clinicians about appropriate criteria for ordering the imaging when they suspect infective endocarditis.
Rapid diagnosis, effective treatment and prompt recognition of complications are essential for a good outcome of infective endocarditis, which carries a high morbidity and mortality rate.
In 23% of cases of infective endocarditis, the diagnosis is made after more than 30 days from the onset of symptoms [1].
Diagnosis of definite infective endocarditis must meet one of the following: 1) two major criteria, 2) one major with three minor criteria, or 3) five minor criteria.
Clinical and economic outcomes of infective endocarditis, Infect Dis 2015; 47; 80-87.
The diagnosis is traditionally based on the modified Duke criteria, which provide a useful framework for the investigation of patients suspected of having infective endocarditis.
A set of diagnostic aids between infective endocarditis and small-vessel vasculitis has been previously outlined (Table 2) [8].
Carr, "Imaging of infective endocarditis with cardiac CT angiography," Journal of Cardiovascular Computed Tomography, vol.
Temporal trends in infective endocarditis in the context of prophylaxis guideline modifications: three successive population-based surveys.
Infective endocarditis complicated with rapidly progressive glomerulonephritis: a case report.
Profile of infective endocarditis at a tertiary care center in Brazil during a seven-year period: prognostic factors and in-hospital outcome.
2 The valve aortic and mitral area for young patients with infective endocarditis - 40 pcs3.