Inflammatory heart disease: infective endocarditis

Infectious endocarditis - inflammation of the internalheart walls, heart valves, aortic walls. The classic causative agent of this disease is a green streptococcus. Previously, this disease was called subacute septic endocarditis. Most doctors considered it the final stage of development of rheumatism. Now infectious endocarditis is considered an independent disease that affects both altered and intact endocardium.

In recent years, the incidence of infectiousendocarditis increased several times. This is due to a decrease in the immunological reactivity of the population, as well as an increase in virulence of pathogens as a result of irrational use of antibiotics. Men are more often ill, in half of cases, endocarditis infectious develops against the background of an existing heart defect.

Etiology

In the development of infective endocarditis, a largeimportant are streptococci, staphylococci, pneumococci, strains of salmonella, fungi. Infective endocarditis, affecting the right heart, develops after repeated intravenous injections of substances of doubtful purity by drug addicts. Another reason for right-sided endocarditis is the methods of endovascular cardiology. The disease often develops in patients with angiogenic sepsis, with suppuration of a thrombus located in the ventricle of the heart with transmural infarction.

The contributing factors of development are dental, gastroenterological and urological diagnostic and therapeutic procedures, burns, otolarynological operations.

Clinical picture

Often infectious endocarditis appearsunnoticed for the patient. There is general malaise, weakness, fever with chills, headache. Sometimes the onset of endocarditis is acute and resembles malaria, brucellosis or typhus. In rare cases, the disease can begin with hemiplegia, low back pain, speech problems. This occurs as a result of embolism of the vessels of the brain, kidneys or spleen.

When examining patients determine the discolorationskin. She acquires a typical for this disease shade of coffee with milk, which is a manifestation of progressive anemia. Later on there are swelling and pastosity of the face. On the feet there is a hemorrhagic rash. Typical is the change of fingers: they take the form of tympanic sticks, and nails - watch glasses.

Patients complain of pain in the heart,shortness of breath, palpitations. If aortic, mitral or tricuspid valve is affected, the corresponding symptoms of their failure appear. The defeat of the myocardium is manifested by a weakening of tones, tachycardia, proto-diastolic rhythm of the gallop, rhythm disturbances - arrhythmias, blockades. Perforation of the valve is possible.

When infectious endocarditis is often affectedkidneys with the development of focal or diffuse glomerulonephritis, which is manifested by increased blood pressure, the appearance of edema, and urinary syndrome. It is possible to develop a spleen infarction, thromboembolism of pulmonary artery branches, and infarct-pneumonia.

Diagnostic tests

For the diagnosis of endocarditis use ECG, echocardiography, chest X-ray. From laboratory studies, an overall blood and urine test is prescribed, blood culture for blood culture.

Treatment

If the infection is clinically suspectedendocarditis, treatment should immediately begin with the appointment of antibiotic therapy. Before determining the type of pathogen, the patient is prescribed broad-spectrum antibiotics. The introduction of antibiotics should be intravenous and intramuscular.

The prognosis of the disease depends on the type of pathogen, its sensitivity to antibiotics, the presence of complications, the age of the patient.