Endocarditis: Symptoms, Risks, and Treatment Options - Cardiology

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Endocarditis is an infection of the inner lining of the heart chambers and valves, often caused by bacteria entering the bloodstream and attaching to damaged areas of the heart. Given your history of mitral valve prolapse with regurgitation, your symptoms of irregular heartbeats, chest pain, vomiting, and low-grade fever raise concerns about the possibility of endocarditis, especially following dental procedures that can introduce bacteria into the bloodstream.


Symptoms of Endocarditis
Common symptoms of endocarditis include:
- Fever and chills
- Fatigue
- Shortness of breath
- Heart murmurs (new or changed)
- Unexplained weight loss
- Night sweats
- Petechiae (small, pinpoint red or purple spots on the skin)
- Pain in the joints or muscles
In your case, the irregular heartbeats and chest pain could be indicative of heart strain or inflammation, while the vomiting and fever suggest a systemic infection. The presence of a pus-filled lesion in your gums is also concerning, as it could be a source of bacteria that may have entered your bloodstream.


Risks
Individuals with pre-existing heart conditions, such as mitral valve prolapse, are at a higher risk for developing endocarditis, particularly after invasive procedures like dental work. The bacteria from the mouth can enter the bloodstream during such procedures, especially if there is bleeding or infection in the gums.

Treatment Options
If endocarditis is suspected, it is crucial to seek medical attention promptly. Diagnosis typically involves:
- Blood cultures to identify the causative organism
- Echocardiogram (either transthoracic or transesophageal) to visualize the heart valves and chambers for signs of infection or damage
Treatment usually consists of:
- Antibiotics: Intravenous antibiotics are the standard treatment for endocarditis. The choice of antibiotic will depend on the type of bacteria identified.

- Surgery: In some cases, if there is significant damage to the heart valves or if the infection does not respond to antibiotics, surgical intervention may be necessary to repair or replace the affected valve.


Recommendations
1. Immediate Medical Consultation: Given your symptoms and recent dental work, it is essential to consult your cardiologist or seek emergency medical care. They may recommend further testing, such as blood cultures and an echocardiogram, to assess for endocarditis.


2. Monitor Symptoms: Keep track of any changes in your symptoms, including the progression of fever, the appearance of new symptoms, or worsening of existing ones.

3. Oral Hygiene and Follow-up: Continue to maintain good oral hygiene and follow up with your dentist regarding the gum lesion. If it persists or worsens, it may need to be evaluated and treated to prevent further complications.

4. Antibiotic Prophylaxis: Ensure that you are following the recommended guidelines for antibiotic prophylaxis before any dental or surgical procedures, especially given your heart condition.

In summary, your symptoms warrant immediate evaluation for potential endocarditis, particularly in light of your recent dental treatment and existing heart condition. Prompt intervention can significantly improve outcomes and prevent serious complications.