In the therapy of endocarditis, antibiotics are used against the germs and drugs against the inflammatory reactions, in addition to treating underlying diseases and sequelae. Often, a surgical procedure is also necessary. You can find out exactly how endocarditis is treated here.
Treating endocarditis
Here’s what the treatment of endocarditis looks like in concrete terms:
- The most important pillar of therapy is the administration of antibiotics – this is started even on suspicion, before the pathogen has been detected. The duration of therapy is adjusted individually (usually it is four to six weeks) – especially in rheumatic endocarditis, antibiotic treatment must be continued over a longer period of time to prevent a relapse. In addition, aspirin and cortisone are given in rheumatic endocarditis.
- In severe acute courses and in the case of chronic irreparable consequential damage to the valve apparatus, surgery must often be performed on the heart and the inflamed or chronically deformed heart valve must be replaced by a prosthetic heart valve. This effectively removes the focus of inflammation and improves the performance of the heart again. However, artificial prostheses have two disadvantages: Their lifespan is limited and they require lifelong medication to thin the blood. Sometimes the surgeon can repair the defective valve by tightening or stretching it so that no artificial prosthesis is needed. As a last measure in severe heart failure after heart valve damage, heart transplantation may also be considered.
- In addition, the sequelae of chronic heart valve damage such as cardiac arrhythmias or heart failure are additionally treated individually.
- If endocarditis occurs as a concomitant reaction in the context of other serious diseases of the organism, such as chronic polyarthritis, the treatment must be directed to the elimination of the underlying problem, in this case again an immune disease.
Often it is not possible to prevent initial disease, but with the targeted and consistent treatment of the expired endocarditis at least control or contain a progression of inflammation and valve damage.
Higher risk for those already affected
Once you have had endocarditis, you are, in principle, more at risk of getting it again. For this reason, affected individuals – as well as patients with an artificial heart valve and a severe congenital heart defect – should receive a preventive – usually single – dose of antibiotics (endocarditis prophylaxis) for the rest of their lives before any planned diagnostic or therapeutic medical procedure in which germs could enter the bloodstream (for example, tooth removal, gastrointestinal endoscopy, surgery in the nasopharynx, for example).
However, it has been shown that in the case of certain valve defects, a number of interventions do not lead to an increased risk of endocarditis, which is why the formerly quite strict guidelines were relaxed somewhat in 2007.
To prevent the disease from worsening, regular follow-up examinations by a physician are recommended, during which the drug therapy may also be adjusted. In addition, those affected should have a cardiac passport issued, which they should present with all (planned) treatments and also not forget when on vacation.
Important information for endocarditis sufferers
Here’s what endocarditis sufferers should keep in mind:
- Always have and present the cardiac passport
- Good, regular dental hygiene with a soft toothbrush.
- In the case of bacterial infections early and sufficiently long antibiotic therapy prescribed by the doctor to have.
