Frequency (Epidemiology)
In the Federal Republic of Germany, approximately 2 to 6 new cases of endocarditis occur per year among 100,000 inhabitants. On average, men are affected twice as often as women. The age peak of the disease endocarditis is 50 years.
Since the introduction of antibiotic therapy, the overall incidence of the disease has not decreased (which could be assumed due to the improved therapy). However, the inflammation of the heart valves occurs today about 15 years later than before and other germs are responsible as triggering factors. Various factors lead to a significant increase in the risk of disease: bacteria circulating in the blood make it easier for them to adhere to the sensitive inner wall of the heart, which is medically called the endocardium.
This skin, consisting of connective tissue, smooth muscle cells and elastic fibers, also covers the heart valves. This explains why people with a healthy heart are less likely to develop endocarditis. In the first year after the replacement of a heart valve (artificial heart valve), about 2 to 3% of those who have undergone heart valve surgery develop heart valve inflammation.
In the following years the risk decreases again. Furthermore, all processes associated with a weakening of the body’s immune system represent an increased risk. These include diseases of the hematopoietic system (white blood cells, so-called leukocytes, perform the important task of defending our body against specific invaders), diabetes mellitus (= diabetes; see diseases of the pancreas) or chemotherapy.
Drug addiction promotes the occurrence of heart valve inflammation (endocarditis), since intravenous injections often lead to the spread of germs, which then enter the right heart directly via the superior vena cava and mainly damage the valve separating the right atrium and ventricle (this valve is called the “tricuspid valve” because of its three valve leaflets, from Latin tri = three). In rare cases, the pulmonary valve leading to the pulmonary circulation may also be affected.
- Congenital heart valve defects (mostly the valves of the larger left ventricle are affected, i.e. the aortic valve and the mitral valve separating the atrium and ventricle)
- Congenital malformations of the heart
- Heart surgery