INFECTIVE endocarditis is an infection of the lining of the heart, most commonly the heart valves. The heart valves separate the upper heart chambers (atria) from the lower, and also the pumping chambers (ventricles) from the lungs and aorta from the right and left ventricles, respectively. They close to allow filling of the heart chambers and open to allow forward flow of blood from one chamber to the next.

Infection of the heart valves usually leads to malfunction of the valves and leaking of the valves.

WHO IS AT RISK FOR INFECTIVE ENDOCARDITIS?

Infective endocarditis rarely affects people with normal heart valves but affects patients who have a history of abnormal heart valves, such as rheumatic heart disease (RHD) and congenital heart disease such as hole in the heart. In addition to having abnormal valves to begin with, circumstances that may lead to circulation of bacteria in the blood increase the risk of the valves becoming infected. Some examples include intravenous drug abusers and patients undergoing surgery for infections in other parts of the body, or even dental cleaning.

WHY WOULD DOCTORS SUSPECT YOU HAVE INFECTIVE ENDOCARDITIS?

We may suspect that you have infective endocarditis if you have a fever with no apparent cause, generally feeling unwell, poor appetite, and in severe cases symptoms of heart failure such as cough or shortness of breath.

HOW DO WE CONFIRM THE DIAGNOSIS?

Confirming the diagnosis of infective endocarditis will usually need:

1. Blood cultures: We collect sample of blood and test for bacteria.

2. Echocardiogram: Heart ultrasound.

These are they main tests, but other tests may be needed.

HOW WILL YOU BE TREATED? IS THERE A CURE?

Since this is a bacterial infection, treatment will include antibiotics. You will need to be admitted to hospital, for a period of two to six weeks, depending on whether the doctors can identify the bacteria and the type of bacteria. And, if heart failure symptoms or signs are present, treatment of the the heart failure as well.

In severe cases, where the risk of stroke is high, heart surgery may be performed to remove the infected portion on the heart valves.

HOW CAN YOU LOWER YOUR RISK OF INFECTIVE ENDOCARDITIS?

If you know you have an abnormal heart valve, it is important to tell your treating doctors. You may need antibiotics before any procedures such as dental cleaning, to lower your risk.

Dr Claudine Lewis is an adult cardiologist and medical director at Heart Smart Centre in Montego Bay. She is also a cardiologist at the Cornwall Regional Hospital and an associate lecturer with the University of the West Indies. Questions may be sent to questions@heartsmartcentre.com and for additional information call 684-9989 or visit the website www.heartsmartcentre.com