Endocarditis

heart valve inflammation, inflammation of the inner wall of the heart

Introduction

Inflammation of the heart valves (endocarditis) is a potentially life-threatening disease, usually caused by microbial pathogens such as viruses, bacteria or fungi. It is not uncommon for structural damage to the heart valves to be the result, accompanied by a functional defect.

Symptoms of endocarditis

Initially, the symptoms of endocarditis are often similar to influenza and cannot be distinguished from other general diseases, which makes a clear diagnosis difficult. In the foreground there can also be weight loss, chills, sweating, muscle and joint pain. After a prolonged course of the disease, a pale skin color due to anemia is often observed, associated with a general feeling of weakness.

In the case of existing, hemodynamically relevant (i.e. affecting the blood flow) valve damage, shortness of breath is the main symptom of endocarditis: if a heart valve no longer closes properly (= valve insufficiency), blood flows back into the atrium during the phase of filling the heart chambers (the phase of heart action is called diastole) and this leaks out (medically: it dilates). The backflowing blood is also responsible for the fact that larger amounts of blood than normal have to be pumped from the heart into the body. As a result, the heart enlarges (hypertrophy); comparable to a highly trained muscle.

This naturally occurring process of adaptation of the heart muscle to extra work becomes harmful when it becomes so large that the blood vessels supplying it can no longer guarantee an adequate supply of oxygen. For men, this is the case when the so-called critical heart weight of 500g is exceeded, for women it is 400g. Endocarditis can result not only in leaks in the valves, but also in narrowing (so-called stenoses) of the outflow tract.

As in valve insufficiency, when the heart valve is narrowed (stenosis), while the heart muscle contracts in the so-called ejection phase (systole), not enough oxygen-rich blood reaches the internal organs and the affected person also suffers from shortness of breath (medical term: dyspnoea). One way to diagnose endocarditis is the so-called swallowing echo. In this procedure, the functioning of the heart is tested by swallowing an ultrasound probe.

  • Fever, initially around 38°C
  • Slight physical fatigue
  • Loss of appetite
  • Headache.