Home
 

Infective Endocarditis: Complications and Prognosis

 

complications of endocarditis

Patients with infective endocarditis can develop the following complications:

  • Myocardial infarction - This complication can occur as a result of the microthrombi forming within the left ventricle, getting dislodged, entering the aorta, and then getting into the coronary arteries. Not only do these emboli (thrombus which was dislodged is called an embolus) block the blood flow within the heart, they also contain a vast amount of bacteria, which can further complicate the condition of the patient.
  • Pericarditis - Spread of the inflammation can cause the pericardium to be involved in the inflammatory processes leading to pericarditis. Clinical presentation of pericarditis and myocardial infarction are quite similar, however there are a number of distinctions. The pain caused by pericarditis usually radiates to the lower portion of scapula on the back, or it doesn’t radiate at all. The pain doesn’t change with exertion. Pain gets worse when the patient is lying down or when takes a large breath in.
  • Cardiac arrhythmia - Inflammation caused by infective endocarditis can damage the electrical conduction system of the heart often leading to atrioventricular blocks. This complication can often lead to the need for installing a pacemaker.
  • Cardiac valvular insufficiency - Infective endocarditis, overtime, leads to the destruction of heart valves preventing them from fully closing and creating a backward flow of blood which creates a major strain on the heart. Overtime, this leads to congestive heart failure as the heart is no longer able to handle the added strain.
  • Congestive heart failure due to valvular (especially aortic) insufficiency - the most common complications of subacute endocarditis. It develops usually after months if the endocarditis is left untreated. Sometimes, however, it can appear a full year after the disease was treated using antibiotics.
  • Stroke and organ damage - Infective endocarditis triggers the formation of parietal blood clots. These thrombi contain a large number of bacteria which can sometimes break loose and travel to the brain, lungs, kidneys, abdominal organs (mesenteric and splenic abscesses or infarct) and extremities. This can result in stroke or formation of abscesses in the affected organs and tissues. Moreover, if the infective endocarditis was caused by fungi, this can result in severe consequences since fungi are more resistant to therapy than bacteria.  Due to the use of antibiotics, the emboli are usually sterile, causing a lot less damage than in the pre-antibiotic era. If the patient has an acute form of infective endocarditis caused by S. aureus, multiple abscesses can quickly form throughout the body damaging the kidneys, the heart and the brain.
  • Aortic root or myocardial abscesses - These abscesses form as a result of spreading infection throughout the blood stream and are usually the result of an acute infective endocarditis.
  • Glomerulonephritis and acute renal failure - Glomerulonephritis happens as a result of the damage caused by immune complex deposition, emboli causing renal infarction, thrombotic microangiopathy and direct invasion of the parenchyma by microorganisms. All these factors can lead to acute renal failure which immediately calls for hemodialysis until the patient is stabilized.

Prognosis

Prognosis of infective endocarditis largely depends on whether complications develop or not. If it is left untreated, this disease is usually fatal. Early detection and proper treatment can be lifesaving. Overall the mortality rate of infective endocarditis is 14.5%; however the numbers vary largely depending on the microbial pathogen that has caused the disease. For example, acute endocarditis caused by S. aureus is the most dangerous with 30-40% mortality rate.

Cure rates depending on the type of infection that caused infective endocarditis:

  • Streptococcus viridans and bovis – 98%
  • Enterococci and Staphylococcus aureus in people who abuse intravenous drugs – 90%
  • Community-acquired Staphylococcus aureus in people who do not abuse intravenous drugs – 60-70%
  • Aerobic gram-negative organisms – 40-60%
  • Fungal organisms – less than 50%.

 

 

 
 
Featured Articles

Can Depression Cause a Heart Attack?

Can Depression Cause a Heart Attack?

Heart disease and depression are both very serious and common conditions. They affect millions of people worldwide, and sometimes occur...

Does living in the mountains improve the health of…

Does living in the mountains improve the health of your heart?

Mountains have always been associated with the idea of strength, beauty and magnificence.  Many people consider mountains a symbol of...

Breathing Exercises for Your Heart

Breathing Exercises for Your Heart

Everyone knows how good morning exercises are for our body and health, but we know very little about the benefits...

Can You Die from a Heart Attack During Sex?

Can You Die from a Heart Attack During Sex?

Sex is an important part of most couple’s relationship and life. Therefore, it is not surprising that some people worry...

Rare Causes of Hypertension

Rare Causes of Hypertension

Most likely you’ve heard about a condition called hypertension or high blood pressure. Nowadays, it is very common in a...

The C-Reactive Protein

The C-Reactive Protein

Blood tests are a great way to learn many things about the patient’s state of health and make a correct...

How do Positive Emotions Impact the Heart?

How do Positive Emotions Impact the Heart?

There are a huge number of factors that determine and impact the heart's wellbeing. These include diet, physical activity, lifestyle,...

Is Our Generation More Susceptible to Heart Diseas…

Is Our Generation More Susceptible to Heart Diseases?

Despite all the advancements of modern medicine, the number of people affected by cardiovascular diseases in developed countries is on...

How Bacterial Pneumonia Damages the Heart

How Bacterial Pneumonia Damages the Heart

Bacterial pneumonia is an infection that affects one or both of the lungs. It creates an inflammation of the alveoli...

The Best Cardio Exercises For Your Heart

The Best Cardio Exercises For Your Heart

What is the driving force behind our lives? Certainly, exercise is one of the things that come to mind. Not...

Are Heart Problems Hereditary?

Are Heart Problems Hereditary?

Heart disease is currently the world's leading cause of death. Heart disease is not just one condition but a combination...

Computers: Can They Harm Your Heart

Computers: Can They Harm Your Heart

Most young and middle-aged people nowadays are working in offices equipped with computers and laptops. These people spend a tremendous...

10 Rules of Life for Patients with Varicose Veins

10 Rules of Life for Patients with Varicose Veins

The term “varicose veins” most commonly refers to the veins in the lower extremities because such veins mostly develop in...

Can Regular Consumption of Coffee and Energy Drink…

Can Regular Consumption of Coffee and Energy Drinks Damage the Heart?

At times, we all feel sleepy, tired, and devoid of energy - right after getting up in the morning, in...

Can Lack of Sleep Cause Heart Disease?

Can Lack of Sleep Cause Heart Disease?

Life in a big city is hectic with everyone hurrying somewhere, always being late and getting stressed due to the...

Are Women Less Susceptible to Heart Disease?

Are Women Less Susceptible to Heart Disease?

It is a well-known fact that women tend to live longer than men1. We may ask what is the reason...


To learn more about Cardiology, we recommend the following websites:

AHA-logoACC logoWHOwhf logowikipedia

ok