- Symptoms of bacterial endocarditis
- Why tooth problems can cause endocarditis
- How is endocarditis treated
Bacterial endocarditis is an infection that affects the internal structures of the heart, called the endothelial surface, mainly the heart valves, due to the presence of bacteria that reach the bloodstream. It is a serious disease, with a high chance of mortality and that can be associated with several complications, such as stroke, for example.
The use of injectable drugs, piercings , dental treatments without previous antibiotic therapy, intracardiac devices, such as pacemakers or valve prostheses, as well as hemodialysis, can increase the chance of bacterial endocarditis. However, the most common cause in countries like Brazil, remains rheumatic valve disease.
There are two types of bacterial endocarditis:
- Acute bacterial endocarditis: it is a rapidly progressive infection, where high fever, malaise, falling general condition and symptoms of heart failure appear, such as excessive tiredness, swelling of the feet and legs, and shortness of breath; Subacute bacterial endocarditis: in this type it may take a few weeks or months to identify endocarditis, showing less specific symptoms, such as low fever, tiredness and gradual weight loss.
The diagnosis of bacterial endocarditis can be made through tests such as echocardiography, which is a type of ultrasound in the heart, and through blood tests in order to identify the presence of the bacterium in the bloodstream, being characterized as a bacteremia. Learn more about bacteremia.
Symptoms of bacterial endocarditis
Symptoms of acute bacterial endocarditis can be:
- High fever; Chills; Shortness of breath; Small points of bleeding in the palms and feet.
In subacute endocarditis, the symptoms are usually:
- Low fever; Night sweat; Easy tiredness; Lack of appetite; Thinness; Small painful lumps in the fingers or toes; Rupture of small blood vessels in the white part of the eyes, in the roof of the mouth, inside the cheeks, in the chest or on your fingers or toes.
If these symptoms are present, it is advisable to go to the emergency room as soon as possible because endocarditis is a serious disease that can lead to death quickly.
Why tooth problems can cause endocarditis
One of the main causes of endocarditis is the performance of dental procedures such as tooth extraction or treatment for caries. In these cases, caries bacteria and those naturally present in the mouth can be carried by the blood until they accumulate in the heart, where they cause tissue infection.
For this reason, people at high risk of endocarditis, such as patients with prosthetic valves or pacemakers, need to use antibiotics 1 hour before some dental procedures, in order to prevent bacterial endocarditis.
How is endocarditis treated
The treatment of endocarditis is done with the use of antibiotics, which can be oral or applied directly to the vein, according to the microorganism identified in the blood. In more severe cases, where there is no good result with the use of antibiotics and depending on the size of the infection and its location, surgery is indicated to replace the heart valves with prostheses.
Prophylaxis of endocarditis is done especially in people who are at high risk of developing endocarditis, such as:
- People with artificial valves; Patients who already had endocarditis; People with valve disease and who have already had a heart transplant; Patients with congenital heart disease.
Before any dental treatment, the dentist should advise the patient to take 2 g of amoxicillin or 500 mg of Azithromycin at least 1 hour before treatment. In some cases the dentist will have to advise the use of antibiotics for 10 days before the start of dental treatment. Learn more about treatment for bacterial endocarditis.
