Heart Infection: Symptoms, Causes, Treatment

What are the symptoms of heart infection?

Heart infections, also known as infective endocarditis, can present with various symptoms. These may include:

1. Fever: Persistent fever is a common symptom, often accompanied by chills.
2. Fatigue: Unexplained fatigue or weakness, which may be severe.
3. Heart Murmur: An abnormal heart sound (murmur) due to turbulent blood flow through the heart valves affected by infection.
4. Shortness of Breath: Difficulty breathing or increased respiratory rate.
5. Chest Pain: Sometimes described as sharp or stabbing, often exacerbated by breathing deeply or coughing.
6. Joint Pain: Pain and swelling in the joints, especially larger joints like knees.
7. Unexplained Weight Loss: Loss of appetite leading to unintended weight loss.
8. Skin Changes: Small, painless spots on the fingers and toes (petechiae), or under the fingernails (splinter hemorrhages).
9. Night Sweats: Profuse sweating at night, unrelated to room temperature or physical activity.
10. Other Symptoms: Nausea, vomiting, abdominal pain, and changes in mental status (confusion) in severe cases.

It’s crucial to seek medical attention promptly if you experience any of these symptoms, especially if you have a history of heart disease, heart valve problems, or recent dental procedures, as these can predispose individuals to heart infections.

What are the causes of heart infection?

Heart infections, also known as infective endocarditis, are typically caused by bacteria or less commonly by fungi. The most common causes include:

1. Bacteria: Bacteria can enter the bloodstream and settle on damaged or abnormal heart valves or other areas of the heart lining. Common bacteria implicated in infective endocarditis include Streptococcus and Staphylococcus species.
2. Fungi: Fungal infections of the heart are less common but can occur, especially in individuals with weakened immune systems or those who use intravenous drugs.
3. Dental Procedures: Dental procedures that cause bleeding, such as tooth extraction or periodontal surgery, can allow bacteria from the mouth to enter the bloodstream and potentially reach the heart.
4. Intravenous Drug Use: Injecting drugs intravenously can introduce bacteria directly into the bloodstream, increasing the risk of infective endocarditis.
5. Other Infections: Infections elsewhere in the body, such as skin infections or urinary tract infections, can sometimes spread through the bloodstream and affect the heart.
6. Congenital Heart Defects: Structural abnormalities of the heart present since birth can increase the risk of developing infective endocarditis.
7. Medical Procedures: Certain medical procedures that involve invasive devices, such as central venous catheters or prosthetic heart valves, can also increase the risk of infection.
8. Age and Health Conditions: Older age, a history of heart valve disease, rheumatic fever, or previous episodes of infective endocarditis can predispose individuals to developing heart infections.

It’s important for individuals at risk to practice good dental hygiene, receive appropriate prophylactic antibiotics before certain dental procedures if recommended by their healthcare provider, and promptly seek medical attention if they experience symptoms suggestive of infective endocarditis.

How is the diagnosis of heart infection made?

The diagnosis of heart infection, also known as endocarditis, is typically made through a combination of medical history, physical examination, and diagnostic tests. Here are the common steps involved in making a diagnosis:

1. Medical History: The doctor will ask questions about the patient’s medical history, including any previous heart conditions, infections, or surgeries. They will also ask about symptoms such as fever, chills, fatigue, and chest pain.
2. Physical Examination: The doctor will perform a physical examination to look for signs of heart infection, such as:
   • Fever
   • Fast or irregular heartbeat
   • Swelling of the neck veins
   • Swelling or redness around the joints
   • Changes in lung sounds
3. Blood Tests: Blood tests are used to detect signs of infection and inflammation in the body. The tests may include:
   • Complete Blood Count (CBC): to check for signs of infection, such as an elevated white blood cell count
   • Blood Culture: to identify the type of bacteria causing the infection
   • Erythrocyte Sedimentation Rate (ESR) or C-reactive Protein (CRP): to measure the level of inflammation in the body
4. Imaging Tests: Imaging tests may be ordered to visualize the heart and valves:
   • Echocardiogram: uses sound waves to produce images of the heart and valves
   • Transesophageal Echocardiogram (TEE): uses a probe inserted through the mouth to produce detailed images of the heart and valves
   • Cardiac MRI or CT Scan: uses magnetic resonance or computed tomography to produce detailed images of the heart and valves
5. Cardiac Catheterization: In some cases, a cardiac catheterization may be performed to visualize the inside of the heart and arteries:
   • Cardiac Catheterization: uses a catheter inserted through a vein in the leg to visualize the heart and arteries
6. Valve Consultation: If a valve infection is suspected, a cardiologist or cardiothoracic surgeon may perform a valve consultation to evaluate the valve function and plan treatment.
7. Diagnosis Confirmation: The diagnosis is confirmed based on the combination of clinical findings, laboratory tests, and imaging results.

The most common types of bacteria that cause endocarditis are:

1. Staphylococcus aureus (MRSA)
2. Streptococcus viridans
3. Enterococcus faecalis
4. Candida albicans (fungus)

Early diagnosis and treatment are crucial for preventing complications and improving outcomes in patients with heart infection.

What is the treatment for heart infection?

The treatment for a heart infection, also known as endocarditis, depends on the type and severity of the infection, as well as the individual’s overall health. Here are some common treatments:

1. Antibiotics: The primary treatment for bacterial endocarditis is antibiotics, which are usually administered intravenously (IV) in a hospital setting. The choice of antibiotic depends on the type of bacteria causing the infection.
2. Intravenous antibiotics: In addition to IV antibiotics, oral antibiotics may also be prescribed for several weeks after hospitalization to complete the course of treatment.
3. Surgery: In some cases, surgery may be necessary to remove damaged heart valves or infected tissue. This is typically reserved for severe cases where antibiotics alone are not effective or if the infection has caused significant damage to the heart.
4. Valve replacement: If the infection has damaged the heart valves, valve replacement surgery may be necessary.
5. Supportive care: Patients with endocarditis may also receive supportive care, such as:
   • Rest and bed rest to reduce stress on the heart
   • Pain management medication
   • Fluid management to prevent dehydration
   • Monitoring of cardiac function and blood pressure
6. Cardiac rehabilitation: After treatment, patients with endocarditis may require cardiac rehabilitation to help them recover and improve their overall cardiovascular health.
7. Anticoagulation therapy: In some cases, anticoagulation therapy may be prescribed to prevent blood clots from forming in the heart or elsewhere in the body.

Types of antibiotics commonly used to treat endocarditis include:

• Vancomycin
• Gentamicin
• Cefazolin
• Ceftriaxone
• Erythromycin

It’s essential to work closely with a healthcare provider to determine the best course of treatment for a specific case of endocarditis.

Remember, prevention is key! To reduce the risk of developing endocarditis, it’s essential to maintain good oral hygiene, manage underlying medical conditions, and receive regular dental check-ups and medical care.

What is the mortality rate for heart infection?

The mortality rate for heart infection, also known as endocarditis, can vary depending on several factors such as the type of bacteria causing the infection, the severity of the infection, and the patient’s overall health. Here are some general statistics:

Mortality rates for bacterial endocarditis:

• According to the Centers for Disease Control and Prevention (CDC), the mortality rate for bacterial endocarditis is around 15-20%.
• A study published in the Journal of the American College of Cardiology found that the in-hospital mortality rate for bacterial endocarditis was around 12.5%.
• Another study published in the Journal of Infectious Diseases reported a mortality rate of 17.1% for patients with bacterial endocarditis.

Mortality rates for specific types of endocarditis:

• Staphylococcus aureus (MRSA) endocarditis: The mortality rate for MRSA endocarditis is estimated to be around 25-40%.
• Streptococcus viridans endocarditis: The mortality rate for Streptococcus viridans endocarditis is estimated to be around 10-20%.
• Enterococcus faecalis endocarditis: The mortality rate for Enterococcus faecalis endocarditis is estimated to be around 15-30%.

Factors that affect mortality rate:

• Age: Older adults (>65 years) have a higher mortality rate compared to younger adults.
• Underlying medical conditions: Patients with underlying medical conditions, such as heart failure, kidney disease, or liver disease, have a higher mortality rate.
• Delayed or inadequate treatment: Delayed or inadequate treatment can increase the risk of mortality.
• Presence of complications: Presence of complications such as valve damage, abscesses, or septicemia can increase the mortality rate.

It’s essential to seek medical attention immediately if you suspect you have symptoms of heart infection, as prompt treatment can significantly improve outcomes and reduce the risk of mortality.