Prognosis

However, about thirty percent of those affected respond poorly to the medication (antibiotics), resulting in extensive damage to the heart valves. In such cases, an operation with replacement by artificial valves as a life-saving measure is often unavoidable.

Complications

Dreaded complications of heart valve inflammation (endocarditis) are metastases of bacterial deposits on the heart valves. These are called vegetations and can be imagined as small clusters of bacteria growing on the heart valve. These can be carried away with the blood stream by the pumping heart and then interrupt the blood supply to other internal organs by closing the feeding vessel with the “bacterial cluster”.

The consequences of these so-called septic embolisms are functional failures of the corresponding organ with the characteristic symptoms. If the brain is affected, a life-threatening infarction (stroke = apoplexy) is imminent. If the vessels supplying the lungs are blocked (rarely is the pulmonary artery itself blocked by a clot, since it has the largest diameter), this is primarily accompanied by severe shortness of breath, accelerated breathing (tachypnea), chest pain (chest pain), and in extreme cases by pulmonary embolism, which can be felt as unconsciousness (see below).

If the kidney is no longer sufficiently supplied with blood when the vessel supplying it is moved, the blood can no longer be filtered sufficiently through the small blood capillary loops of the kidney serving as filters (the so-called glomeruli) and urine production stops:Stages of kidney failure: As with all organs, the extent of the functional failures and complaints depends on the size of the closed vessel. Small kidney attacks often go unnoticed, while larger ones are accompanied by sudden flank pain, vomiting, nausea and fever. Due to the damage to the kidneys, blood and proteins are detectable in the urine.

Small clots also lead to punctiform bleeding of the skin (so-called petechiae) and are often an important signpost in the detection of heart muscle inflammation (endocarditis). They typically occur on the finger berries and feet. According to their first descriptor, the internist Sir William Osler (in 1885), the 2 to 5 mm large, non-painful skin changes are called Osler nodules.

This disease should not be confused with Osler’s disease. Heart muscle inflammation (endocarditis) itself, on the other hand, has been known for a long time and could still be detected in 600 to 700-year-old mummies in South America.

Oliguria: too little urine is produced with less than 500 ml in 24 hours
Anuria: no urine or less than 100 ml urine is produced in 24 hours