Rheumatic endocarditis (post-infectious endocarditis) – causes, symptoms & therapy

Rheumatic endocarditis (post-infectious endocarditis)

The doctor describes rheumatic endocarditis (post-infectious endocarditis) as an inflammation of the inner lining of the heart. However, rheumatic endocarditis is not a classic disease, but rather the symptom of rheumatic fever. Rheumatic fever is a late reaction to infections caused by certain bacteria.

What is Rheumatic Endocarditis?

Inflammation of the inner lining of the heart is a symptom of what is known as rheumatic fever . In this condition, the heart valves or the inner wall of the heart are inflamed. Rheumatic fever itself is an autoimmune disease that develops as part of an infection . Certain bacteria are considered to be triggers . Under these circumstances, physicians repeatedly refer to rheumatic endocarditis as post-infectious endocarditis. Rheumatic fever occurs between the 10th and 20th day after infection. The trigger are beta-hemolytic streptococci , which belong to group A.

causes

The causes lie mainly in the – apparently already subsided – infection. Rheumatic endocarditis is not a classic disease, but rather the symptom of rheumatic fever, which can be triggered by certain bacteria as part of an infection. However, not every bacterial infection causes rheumatic endocarditis at the same time.If the disease is treated with antibiotics beforehand , the likelihood of post-infectious endocarditis occurring is low. However, the risk is increased if no medication or only insufficient medication is taken. But not all bacteria can cause rheumatic endocarditis; mainly streptococci bacteria.

symptoms and course

Typical symptoms of rheumatic endocarditis:

  • heart murmurs

Rheumatic endocarditis does not always have to cause immediate symptoms. Rheumatic fever is also known for the fact that the symptoms tend to remain “undetected”. Classic symptoms, which always occur – in the context of rheumatic endocarditis – are tachycardia (accelerated heartbeat) and clearly changed heart sounds.

Depending on the start of treatment or the course of treatment, the course of the disease also takes its course. If the therapy is started in good time, complete healing of the inflammation is possible within four to eight weeks. However, the problem with rheumatic endocarditis is the lack of signs; many physicians only make the diagnosis when conservative therapy is no longer possible and surgical intervention is necessary.

Complications can occasionally occur as the disease progresses. The valvular apparatus of the heart can undergo a chronic change; this can go so far that even heart activity is impaired. The heart valves can scar and subsequently – even years after the rheumatic endocarditis – lead to valve malfunctions . If such an impairment is present, the patient must be operated on and receive a heart valve replacement.

Diagnose

Since rheumatic endocarditis is a type of symptom and not a disease or has no clear signs itself, it is not always easy to diagnose. The first indications that point to a corresponding inflammation are tachycardia (an accelerated heartbeat) and rare pain in the chest area.

Since rheumatic endocarditis only occurs in the context of rheumatic fever, the physician places more value on the symptoms of the main disease – in the context of the diagnosis. These are general symptoms of illness, very high fever or changes on the skin. Those factors further complicate the correct diagnosis of rheumatic endocarditis.

An X-ray examination is ordered as part of the diagnosis; the X-ray provides information about any joint changes that can sometimes bring a clue. Blood tests are also carried out or a blood sedimentation rate test is ordered so that the doctor can determine any inflammation in the blood. If there is a suspicion of rheumatic endocarditis, the doctor will have an ECG written; If cardiac arrhythmia occurs , an ultrasound examination is then carried out. Any disturbances in the heart valves can be detected.

treatment and therapy

If the doctor finds rheumatic endocarditis, rapid therapy must be initiated. If the rheumatic endocarditis remains untreated for a long time, further consequences can occur as heart damage, which ultimately leads to the need for a heart valve replacement. However, if treatment is started on time, no surgery is necessary.

With conservative therapy , the doctor can combat the inflammation of the inner lining of the heart. However, the healing time is between four and eight weeks; in the case of rheumatic endocarditis, the patient must be patient. Especially in the period of acute illness, the patient must prioritize permanent protection. That means, among other things, strict bed rest. Antibiotics – such as penicillin – are taken for about ten days.These ensure that the inflammation is contained. Acetylsalicylic acid is also prescribed; that provides relief from pain and fights inflammation at the same time. If the doctor does not notice any significant improvement or if the patient’s condition deteriorates, cortisone therapy is administered. If the disease is in an advanced stage, surgical treatment is mainly carried out.

prevention

Rheumatic endocarditis can only be prevented if the patient – in the context of rheumatic fever – takes regular medication or has the disease treated in good time.

Dorothy Farrar

Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.

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