What can cause Endocarditis?

[Jkm7]

I have bovine tissue valve and my surgeon, cardio and dentist all insist I premedicate for every dental visit. I wouldn't dream of not.

 

[marie]

I have porcine and both my cardio and dentist agree that I need them. I went in this week with an emergency at the dentist and they gave me antibotics in the office before they started the extraction.

 

[ottagal]

If anyone is interested, the AHA has a short explanation of the new guidelines for prophylactic antibiotics in the prevention of infective endocarditis (IE).
http://www.americanheart.org/presenter.jhtml?identifier=3047051

The complete guidelines and full explanation are published in Circulation. As others have mentioned, strep or staph bacteria are primarily responsible for IE. The most important thing we can do to protect ourselves from a dental perspective is practice scrupulous daily dental hygiene.

Recently, my cousin and girlfriend's mother developed heart damage and the both were told that it was due to a 'virus'....scary stuff...

 

[SHEEPDOG]

What about this?

What about this?

Didn't I recently read in here somewhere that OSTEOMYLITIS (sp?) and ENDOCARDITIS are buddies? Osteo is an infection in the bone. My dwd has it in his spine. If properly treated, I dont know how ANY bug could make it through the drugs they have him on. IV antibiotics, 2 times a day, right to his heart(?). Causes muscle problems too. That is ONE way other than dental. He got the OSTEO from a knee surgery.

 

[ALCapshaw2]

any infection can turn into endocarditis, thats why we need to keep tabs on our colds and wounds and stuff, but this does not merit overuse of antibiotics, the reason the guidelines were recently changed is that prophylactic antibiotics arent that effective against endocarditis, except in very high risk situations. the medical community is re-thinking the amount of antibiotics that they are prescribing because of the recent surge in resistant strains of bacteria.

in my oppinion (read: check with your doc I am not a medical professional, nor did I sleep at a holiday inn last night) the main indication to get checked out for endocarditis is fever of unknown origin, any more than 2 days and I would call my doc and do something, I dont think we need to be checked for endocarditis after every cold, etc, but my docs seem to think that its better to be safe than sorry, if I have a cold or whatever thats lasting unusually long its a good idea for me to go on antibiotics (I also dont have much reserve)

big thing to take home from this is viral infections attacking the heart are totally different from endocarditis, antibiotics arent going to help with a virus, and alot of times these viruses settle in normal peoples hearts, its not necessarily in the endocardium (lining of the heart) more likely in the muscle, which is likely why her EF was reduced (EF is normally not really affected by valve issues till they are advanced, chronic, and cause heart muscle damage, such as enlargement)

hope this helps

morgan

Thanks for that informative response Morgan.

The thought of an untreatable VIRUS ruining a heart is SCARY !

 

[ruthienc1]

some thoughts.......

some thoughts.......

I asked my hubby (cardio) how he would answer Al's question and his reply follows:

This is in reply to Al's question about endocarditis and loss of heart muscle function.
These are usually separate issues. Occasionally a viral infection will attack the heart and cause damage to the heart muscle. This called cardiomyopathy (i.e. heart muscle disease); sometimes it is reversible, and sometimes not; I'm not aware that there is any way to predict outcomes.
There have been large studies of this problem over time. Pubmed (www.pubmed.gov)- a free medical citation index run by the National Library of Medicine -lists 8982 review articles about cardiomyopathy, and 461 reviews under "viral cardiomyopathy". They would probably answer most of your questions.

Infective Endocarditis is different. It is caused by bacteria in the blood which find a place to infect the inner lining of the heart or valves (the endocardium). The commonest symptoms of endocarditis are fever, weakness, and shortness of breath. Endocarditis is very dangerous, and needs to be identified and treated promptly. Unfortunately, it can be quite difficult to identify. There is also a huge literature about this problem. Endocarditis usually does not cause damage directly to the heart muscle, but if there is enough damage to a valve, congestive heart failure can occur.

There is a recently-revised, published guideline for steps to prevent endocarditis. Antibiotics for some forms of dental work are recommended for those who have prosthetic heart valves. You can read the guideline here:
http://www.guideline.gov/summary/summary.aspx?doc_id=11687&nbr=006034&string=endocarditis

Of course, it might be good to ask your doctor about all of this.

David

 

[sue943]

Before anyone gets too complacent about it only affecting compromised hearts...

As far as we are aware there was absolutely nothing in my medical history to make me 'high risk', no heart defects, no rheumatic fever, nothing. So, although unlikely, it could affect anyone although I believe the figures are 20 per million each year so it is just very unlikely and I was very unlucky.

 

[KristyW]

Bina, I did too, not 20 years but 6 or 8 or so. They recently changed the rules .... no more anti-biotics for stenotic native valves, but keep taking them for mechanical. I am not sure about non-native tissue ones.

Not the one you were born with = artificial...take the antibiotics.

 

[debster913]

Not the one you were born with = artificial...take the antibiotics.

My cardio has told me despite my annuloplasty ring, I MUST take antibiotics before every dental procedure. He says it's the same as having anything else that is non-native.

OK, and now I just crapped my pants. Not really. But I have this infection that still hasn't cleared up AND I'm just now getting over a cold.

 

[ALCapshaw2]

Thanks for the links David and Ruthie.

That will keep me busy for a while!

'AL Capshaw'