Endocarditis

Short characteristic of a disease

Endocarditis – the inflammatory process which is formed in an internal cover of heart at an infection, fungus diseases, sepsis, diffusion defeats of connecting fabric, poisonings (uraemia).

By origin allocate a rheumatic and infectious, or septic endocarditis.

Emergence reasons

The infectious endocarditis most often arises because of streptococci, a stick intestinal and pyocyanic, stafilokokk, a protea, other pathological microorganisms.

Also cases of development of an endocarditis owing to the inborn, acquired heart diseases, after installation of prostheses of valves are known, but there is it quite seldom.

The rheumatic endocarditis develops as a complication of the available heart rheumatism.

The risk to ache with an endocarditis increases also at those who already had earlier this disease, suffers from a hypertrophic cardiomyopathy, has AIDS, is on a hemodialysis, uses drugs (a provocative factor: manipulations with veins in aseptic conditions).

Endocarditis symptoms

Symptoms of the endocarditis which developed because of an infection appear throughout the first 2kh weeks after infection. Feelings as are characteristic at flu: fatigue and low temperature. If there was infection with powerful strains, more serious symptoms of an endocarditis can be observed. It can be heat and a fever, reduction of weight, painful feelings in joints, plentiful sweating at night, short wind and steady cough, bleedings under nails, petechias (small red or purple spots on skin).

If the infectious endocarditis caused damage to valves, symptoms of heart diseases can develop if the cardiac muscle inflamed, arrhythmia, heart failure, deterioration in conductivity can be observed. If vessels take part in an inflammation, thrombosis, a heart attack of a spleen or liver begins, aneurisms, bruises on skin can develop. Also the glomerulonephritis, increase in a liver, spleen, insignificant jaundice can be found.

Symptoms of the endocarditis which developed because of rheumatism: an easy indisposition, a fever, temperature increase, heartaches, short wind, heartbeat even at small loading, increase of pulse, abnormally excited action of the heart, shift of its borders. When listening heart systolic or diastolic noise are noted. Reaction of eritrotsitny sedimentation accelerates.

Complications which can develop after an endocarditis: rupture of valves, disturbance of renal function, heart disease. Also decrease in level of leukocytes, hemoglobin is noted, SOE increases.

Diagnosis of a disease

Echocardiographic inspection helps to make the diagnosis – damage of valves, localization and scales of growth of bacterial colonies so comes to light. If the endocarditis infectious to reveal the activator, to determine the level of its sensitivity to antibacterial drugs, is done by blood crops.

Treatment of an endocarditis

Treatment of an endocarditis consists in performing antibiotic treatment (in high doses), immunotherapies (enter antistafilakokkovy gamma-globulin and plasma). To the patient will also appoint immunomodulators (Thymalinum, T-activin), glucocorticosteroid hormones (for example, Prednisolonum), kuraltit, aspirin, trental, heparin.

Also positive effect gives treatment of an endocarditis ultra-violet radiation of blood, carrying out hemosorption, plasma exchange.

For treatment of a septic endocarditis can appoint sodium salt of benzylpenicillin in high doses or drugs from penicillinic group (Methicillinum, Oxacillinum), or cephalosporins, gentamycin.

If to eliminate an endocarditis with performing antibiotic treatment not an udalost, can appoint operation on removal and replacement of the struck valve.

Timely carried out drug treatment allows to achieve steady remission (in some cases on 3-5l), but patients remain disabled. A recurrence of a septic endocarditis can cause severe defeats of valves and heart failure. A high probability of a lethal outcome in endocarditis complication cases a chronic renal failure.

Treatment of the endocarditis caused by rheumatism same, as well as a basic disease: appoint salicylic sodium (aspirin, pyramidon), Butadionum, indometacin, Prednisolonum or Prednisonum. Can appoint as well penicillin. Fractional food, restriction of amount of the consumed salt, reception of vitamins of group B is shown to the patient.

Prevention of a disease

Infectious endocarditis it is possible to warn only effective treatment of infections and sepsis, especially at patients with the acquired or inborn cordial defects.

Prevention of a rheumatic endocarditis consists in prevention of rheumatism both timely and its correct treatment, immunity maintenance.