Thursday, April 28, 2011

Endocarditis treatment

It rapidly damages cardiac sites seeds extra-cardiac sites hematogenously and can progress to death within weeks ,incidence increases in elderly 


The incidence of infective endocarditis in the general population is estimated  approximately at 2 and 6 cases of 100 000 person-years, but significantly higher in patients with underlying valvular heart disease and the abuse of intravenous drugs. In addition, invasive procedures are performed also technically strong health care system can cause infections of the bloodstream and cause blood poisoning. Although historically rheumatic  valvulitis has often been regarded as a predisposing factor in endocarditis, times have changed. mitral valve prolapse, bicuspid aortic disease and aortic valvular heart disease are now the most frequent causes. Furthermore, the prosthetic valve heart defects in about one third of all cases of endocarditis, and affects 1% to 3% of patients after cardiac valvular surgery.


SIGN AND SYMPTOMS

In many cases the infection develops very slowly. Sometimes called subacute bacterial endocarditisor SBE. Symptoms can develop gradually, over weeks or months and may be vague. You tend to feel generally unwell and may have general aches and pains, fatigue, and may be out of food. The fever (high temperature) develops at some point in most cases. In these early symptoms may be caused by many other conditions, the cause of the symptoms can not be diagnosed for a while. Murmurs tend to develop heart. These are sounds that can be heard by a doctor listens to your heart with a stethoscope. murmurs are caused by an abnormal flow of blood through faulty valves or damaged. If you already have a murmur heart of an existing valve problem, the murmur may change or become more intense. A new murmur or change is often what alerts a physician to suspect infective endocarditis.

In some cases, the symptoms pretty quickly and it can be very bad for several days. Speed at which the disease develops depends in part on which bacteria or fungi that cause infection. Some bacteria are more virulent than others.



DIAGNOSIS

Infective endocarditis diagnosis based on symptoms, results of medical examinations and results of diagnostic tests:

Blood cultures show bacteria or microorganisms commonly found in endocarditis. blood cultures, blood tests can be time consuming for the laboratory to isolate specific bacteria causing the infection. Must be taken before antibiotics are started, if you have blood poisoning.

Echocardiogram (heart ultrasound) may show growths, abscesses (holes), the new regurgitation (leakage) or stenosis (narrowing), or an artificial heart valve that has begun to move away from the heart tissue. Occasionally, doctors insert an ultrasound probe in your esophagus or esophageal (TEE) to obtain a very detailed look at heart.

Other signs and symptoms of infective endocarditis included :

Emboli (small clots), bleeding (internal bleeding).
Stroke .
Shortness of breath .
Night sweats.
Loss of appetite or weight loss .
Muscle and joint pain


TREATMENT

When bacteria cause infective endocarditis , identified by blood culture tests ,Doc should start immediately intravenous (IV) antibiotic therapy. Intravenous antibiotics may be administered up to six weeks to control the infection. The symptoms will be monitored during treatment and blood tests to determine the effectiveness of treatment. If damage  of cardiac valves occurs, surgery may be needed to establish the heart valve and improve cardiac function.Treatment of infective endocarditis  starts with prevention. When endocarditis occurs, prompt treatment is necessary to prevent damage to heart valves and for more serious complications, including death...... read more

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