Q. What is Infective Endocarditis (IE)?
A. Infective endocarditis is the infection of the endocardialsurface (the innermost surface)of the heart. It most commonly affects the heart valves, and is characterized by the presence of vegetation on the heart valves where the infecting organism is present.
Q. Who can suffer from Infective Endocarditis?
A. Persons at risk of acquiring this infection are those who are suffering from rheumatic heart disease, congenital heart diseases, age-related degenerative heart diseases and those with intracardiac devices like artificial valves, pacemakers, stents etc.
Q. What are the signs and symptoms of IE?
A. The commonest signs and symptoms of infective endocarditis are fever with chills, generalized weakness, bodyache, backache, loss of appetite, weight loss, difficulty in breathing and chest pain.
Q. Is IE treatable?
A. High degree of suspicion is needed for the diagnosis of infective endocarditis. Early diagnosis and initiation of treatment at the earliest is very important and may be life-saving in many cases.
2-D echo is the most important diagnostic modality. Blood cultures should be sent for the diagnosis of infective endocarditis before starting any antibiotics, to know the infecting organism.
Infective endocarditis is a critical infection and needs intensive management. Patients need to be hospitalized and started on injectable antibiotics. The duration of treatment is longer as compared to other febrile illnesses. It depends on the infecting organism, presence of artificial valve/other intracardiac devices and response to treatment, and may last from weeks to months.
If not treated in time and with appropriate antibiotics, infection may spread via bloodstream to different organs of the body.
Medical treatment alone may not be curative for some patients and surgical repair/removal of the infected valve may be needed.
Q. What is Pericarditis and Pericardial effusion?
A. Pericarditis is the inflammation of the Pericardium (the layer covering the heart) and Pericardial effusion refers to the accumulation of fluid in the space between the heart and this layer.
Apart from the non-infective causes; many infections like viral infections, tuberculosis and less likely bacterial infections can cause these diseases.
Q. How should they be diagnosed and treated?
A. Tapping the fluid and sending it for laboratory tests helps to identify the cause. Treatment depends on the etiology (i.e. the cause for infection, eg. Anti TB treatment for tuberculous pericarditis and effusion). Blood tests and blood cultures are also important for diagnosis.
