Subacute Bacterial Endocarditis

Inflammation of the endocardium or the inner lining of the heart is called bacterial endocarditis. This bacterial infection affects the heart valves, especially the area with congenital birth defects. These defects include a hole in the left and right side of the heart, endocardium or defects of the tendons attached to the heart. It has been found, this condition affects more men than women. When the infection sets in almost suddenly it is called acute bacterial endocarditis. If the infection occurs gradually over a few weeks or months, it is called subacute bacterial endocarditis. This condition is very serious as it can lead to severe heart damage.

What is Subacute Bacterial Endocarditis
Subacute bacterial endocarditis as mentioned above is an inflammation of the heart. It goes undetected for several weeks or months. Bacterial cells begin to grow on the endocardium mostly around the damaged valves. This condition is usually fatal and the average life span of the patient is about 6 weeks to 12 months.

Causes
Subacute bacterial endocarditis causes include strains of streptococci bacterium. These bacterial species include Streptococci viridans, enterococci and coagulase negative staphylococcus. Patients on intravenous drugs are more likely to develop this condition. This is because they may use non-sterile syringes that gives the bacteria direct entry into the blood stream. Thus, they can reach the heart and cause infection of the endocardium. Other causes include dental infections, gastrointestinal procedures, urinary or pelvic surgeries may cause the infectious agents to cause inflammation of the heart. It is commonly seen affecting people with prosthetic heart valves, congenital heart diseases, rheumatic valve dysfunction, hypertrophic cardiomyopathy, etc.

Symptoms
There are no specific symptoms. There are however, a number of different symptoms that indicate the presence of this disease. A mild fever of about 102 °F (38.9 °C) is the most common sign of subacute bacterial endocarditis. Other symptoms include headache, chills, weakness, malaise, cough, breathing problems, joint pain, appetite loss, etc. Subacute bacterial endocarditis symptoms may also include Osler's nodes on fingers and toes. Petechiae, hemorrhages under finger and toe nails, etc. due to emboli. If the emboli reaches the brain it may lead to stroke symptoms, weakness, numbness as well as paralysis. The kidney may get damaged due to emboli and lead to bloody urine. Enlarged spleen is a sign of damage due to emboli caused by subacute bacterial endocarditis.

Diagnosis
When a patient with a history of heart ailments shows signs of kidney damage, hemorrhages, enlarged spleen, etc. it indicates subacute bacterial endocarditis. The doctor may use a stethoscope to listen to heart murmur. A blood test may help in detecting the presence of bacteria causing infection. Echocardiography will help in detecting any abnormalities in the heart wall structure, growth of abnormal tissue, regurgitation of blood through heart valves, etc.

Treatment
Treatment involves the use of antibiotics to get rid of the bacterial agents. The patient may be hospitalized and given intravenous antibiotics. Most of the time patients respond to the therapy within a week of subacute bacterial endocarditis treatment. If the heart valve is damaged, the patient may require surgery. In some cases, the bacteria tend to become resistant to the antibiotics. In such cases, change in the line of antibiotics as well as the doses is carried out.

Complications
Subacute bacterial endocarditis complications may include reinfection by the same or different bacterial species. It may also lead to congestive heart failure, renal diseases and cerebral vascular complications. Thus, it is important to seek immediate treatment.

Subacute bacterial endocarditis is a treatable condition that needs prompt medical care. The prognosis shows it is still fatal in 10 to 70% of the cases. This is taking into consideration their medical history and current health condition. You need to take good care of your heart health. Make sure you report any cut or wound, skin infection, etc. that takes time to heal, to your doctor. Follow the advice of the dentist after any dental procedure. Prevention is the key, especially if you have any underlying heart condition.