In endocarditis (synonyms: Active nonrheumatic pulmonary valve endocarditis; Acute bacterial endocarditis; Acute endocarditis lenta; Acute ulcerative endocarditis; Acute endocarditis; Acute valvular heart disease; Acute infective endocarditis; Acute malignant endocarditis; Acute myoendocarditis; Acute nonrheumatic pulmonary valve endocarditis; Acute nonrheumatic tricuspid valve endocarditis; Acute peri-endocarditis; Acute septic endocarditis; Aortic valve endocarditis due to streptococci; Arthritis in infective endocarditis; Arthropathy in infective endocarditis; Bacterial endocarditis; Bacterial mitral valve endocarditis; Purulent endocarditis; Endocarditis lenta; Endocarditis maligna; Endocarditis ulceropolyposa; Endocarditis ulcerosa; Endocarditis due to pneumococci; Endocarditis due to streptococci; Glomerular disease in subacute bacterial endocarditis; Glomerular disorder in subacute bacterial endocarditis; Glomerulonephritis in subacute bacterial endocarditis; Valvular ulcer; Infective endocarditis; Malignant endocarditis; Mycotic endocarditis; Osler’s nodule; Purulent endocarditis; Reactive arthropathy in infective endocarditis; Sepsis lenta; Septic endocarditis; Subacute bacterial endocarditis; Subacute endocarditis lenta; Subacute ulcerative endocarditis; Subacute endocarditis; Subacute infective endocarditis; Subacute malignant endocarditis; Subacute myoendocarditis; Subacute nonrheumatic tricuspid valve endocarditis; Subacute periendocarditis; Subacute septic endocarditis; Suppurative endocarditis; Toxic endocarditis; Ulcerative endocarditis; Vegetative endocarditis; ICD-10-GM I33. -: Acute and subacute endocarditis) is the inflammation of the inner lining of the heart (endocardium). The endocardium covers the interior of the heart and the heart valves. Endocarditis mainly affects the heart valves. The inflammation can cause severe damage to the heart valves with subsequent valvular defects. The following forms of endocarditis can be distinguished:
- Abacterial endocarditis – caused by antibody reactions; e.g., endocarditis rheumatica (rheumatic endocarditis; as a complication of rheumatic fever); the bacteria enter the blood externally (from outside) or originate from endogenous (internal) sites of inflammation
- Infective endocarditis (IE) – endocarditis caused by bacteria, viruses, fungi; the infection can occur acutely and subacutely (due topathogens see below causes).
- Mixed forms – in this case, an infective endocarditis grafted onto an abacterial endocarditis.
Frequency peak: rheumatic endocarditis occurs predominantly in children and adolescents (in 5- to 15-year-olds, because of the increased incidence of tonsillitis (inflammation of the tonsils) at this age). Rheumatic endocarditis develops in 40-80% of children with rheumatic fever. The incidence (frequency of new cases) for bacterial endocarditis is approximately 3 cases per 100,000 population per year (in Western Europe). Abacterial endocarditis is rarely seen in Western industrialized countries. It remains a problem in poorer developing countries. Worldwide, approximately 15 million people contract the abacterial form. Course and prognosis: The course of bacterial endocarditis is strongly dependent on when antibiotic therapy was started. Other influencing factors are the patient’s age, general condition, and any concomitant heart disease. The course of rheumatic endocarditis is benign (benign) if therapy is given early and is consistent. As a rule, the disease then heals after 4-8 weeks. If therapy is delayed, the risk of changes in the heart valves increases. The lethality (mortality related to the total number of people suffering from the disease) of bacterial endocarditis is 20-30%. The lethality of rheumatic endocarditis in the early phase of the disease is about 1%.
