Endocarditis is an inflammation of the inner layer of the heart. Bacterial (bacterial endocarditis) or severe immune reactions (rheumatic endocarditis) are usually the reason for the inflammation. Endocarditis can cause scarring and growths on the inner layer of the heart, and damage the heart's valves.
The inner layer of the heart (endocardium) covers the entire inside of the heart, including the heart valves. If bacterial endocarditis is present, the endocardium is populated with bacteria. Factors which facilitate such an occurrence are a weak immune system, introduction of bacteria via the blood stream, inflammation in the mouth area, heart malformations, artificial heart valves or surgical procedures on the heart. Acute bacterial endocarditis can develop into a life-threatening condition, so it must be treated immediately with antibiotics.
Rheumatic endocarditis is caused by an overreaction of the immune system after infection with streptococcus bacteria. This immune reaction, known as rheumatic fever, then results in inflammation in the endocardium or in the kidneys. Rheumatic endocarditis can cause damage to the heart valves and heart valve defects.
Bacterial endocarditis usually occurs in an acute form. It is accompanied by a high fever, reduced performance and a general feeling of discomfort. However, it can also develop slowly and present with almost imperceptible symptoms in exceptional cases. The symptoms of rheumatic endocarditis are generally less dramatic than those of bacterial endocarditis. The disease usually manifests itself with unspecific symptoms such as a mild fever and fatigue. Therefore, evidence of rheumatic fever sometimes only appears when a patient develops a heart murmur; it is caused by the disease in the heart valves.
Examinations used to diagnose endocarditis include auscultating the heart with a stethoscope, blood tests as well as an echocardiography.
Both bacterial and rheumatic endocarditis are treated with antibiotics. Additional anti-inflammatory medications are also administered.
If there is damage to the heart valves and heart valve defects, surgical treatment options are used. Find out more in the chapter entitled Heart valve surgery.