Although the inflammatory process on the heart valves can not be directly seen by the doctor, there are some tools that facilitate the diagnosis. It is therefore important for the doctor's medical history, in particular preceding tonsillitis or joint inflammation and other complaints. During the physical examination, he pays particular attention to bleeding into the skin and mucous membranes and listening to heart sounds.
Diagnosis by heart ultrasound
In heart ultrasound, stronger inflammations, deposits and changes in the heart valves can be shown. An ECG shows whether the myocardium is also affected by the inflammation (myocarditis). If endocarditis is suspected, blood cultures are used several times to identify the underlying germ as much as possible. This is the best way to find a suitable antibiotic or fungicide.
Complications and course
The most serious complication of acute bacterial endocarditis is the life-threatening general infection of the whole organism (sepsis), which is repeatedly inflamed by the inflammatory "smoldering fire" in the endocardium and can lead to death. In addition, individual particles of the inflammatory deposits can detach from the heart valves, enter the blood stream into the brain, clog important vessels there and thus cause a stroke.
If the acute phase is survived, irreparable heart valve damage can develop, especially in the case of chronic recurring endocarditis, which in the long run can weaken the heart muscle, impair cardiovascular function and also damage the lungs. An advanced defect of the most commonly endocarditis-affected mitral and aortic valve may eventually result in heart failure, as well as the risk of having a certain heart rhythm disorder that increases atrial fibrillation. This irregular, chaotic atrial rhythm favors the formation of blood clots, which in turn can enter the brain and trigger strokes.
The long-term effects of endocarditis depend essentially on the early diagnosis and effective treatment - especially as a endocarditis-damaged heart valve is particularly prone to be repeatedly colonized by pathogens due to the increased mechanical stress.
In the case of rheumatic endocarditis, the therapy can be used in good time. Both acute damage to the heart valves and chronic consequential damage can be largely avoided by recurring inflammatory processes. In the acute form of bacterial endocarditis must be expected in the modern age of medicine in 30 to 40 percent with deaths.