Endocarditis: causes and symptoms

An inflammation of the connective tissue of the heart is usually the result of a bacterial infection. It often affects children and adolescents and can lead to severe heart valve damage. The endocardium (endo = inside and card = on the heart) are the connective tissue structures that partially line the heart interiors and also form the heart valves. Through the pumping action of the heart muscle and the resulting bloodstream, the freely moving parts of the endocardium, like the valves of a motor, remain in constant motion and are exposed to such strong mechanical stresses.

Endocarditis: life-threatening inflammation

Inflammatory endocardial events known as endocarditis can cause severe scarring, adhesions, and functional impairment of the heart valves, which have a profound effect on cardiac output and, therefore, circulatory function. Acute endocarditis is potentially life-threatening - and is fatal in more than 15 percent of cases.

Causes and forms of endocarditis

Endocarditis usually occurs either as a reaction of the immune system after a streptococcal infection (rheumatic endocarditis) or in inflammatory processes caused by microbes (infective endocarditis). Particularly often the mitral valve is affected, ie the flap between the atrium and the chamber in the left heart.

  • Rheumatoid endocarditis often affects not only the endocardium, but also the entire myocardium and pericardium. The trigger is a previous infection with a specific bacterial pathogen type. By a faulty control of the body's defense, it can then lead to an overreaction of the immune system, not the pathogens, but the body's own tissue is attacked - in this case, the endocardium, especially the heart valves. This reaction belongs to the autoimmune diseases.
    In more rare cases, other diseases can trigger such non-infectious (abacterial) endocarditis. These can cause inflammation of the connective tissue throughout the body - and thus also inflammation of the connective tissue heart valves. These include, for example, chronic polyarthritis, Bechterew's disease and lupus erythematosus.
  • In contrast, in infective endocarditis, inflammation of the valve tissue is directly triggered by bacteria that settle and multiply in situ (bacterial endocarditis). In addition, fungi can cause endocarditis.

Symptoms of endocarditis

Rheumatic endocarditis is more common in children or adolescents than in adulthood. A bacterial endocarditis can be very sudden (acute form) and then quickly lead to high fever, weakness and joint problems, sometimes skin changes (small bleeding) and shortness of breath.

The more common subtle (subacute) form tends to focus on slow-developing nonspecific symptoms such as fatigue, fatigue, decreased performance, mild elevation of temperature, nocturnal sweating, or decrease in red blood pigment. Not infrequently, the possibility of severe heart disease is at first overlooked and only considered during the (new) occurrence of heart murmur during interception.

Prolonged existence can lead to symptoms of heart failure. If an endocarditis is detected too late, inflammations can repeatedly form on the previously damaged heart valve and cause irreparable damage to the heart valves (chronic course).

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