Your heart is one of the most amazing organs in our body. But sometimes, a small germ that enters our body can travel to the heart valves and cause a bigger problem than you think. Today we are going to talk about such a serious and life-threatening condition called 'Infective Endocarditis' and why it requires surgery. Although this is a bit complicated topic, let's try to understand it simply.
Simply put, what is Infective Endocarditis?
This is what happens: Usually, when we have a tooth extracted, have an endoscopy, or have other surgery, germs like bacteria or fungi can enter our bloodstream. Normally, these germs cannot cause much damage to the valves of a healthy heart. They have the ability to resist infection.
However, if there is a weakness, disease, or congenital problem in your heart valves, the germs that enter the blood can stick to those valves like seeds sprouting in fertile soil, take root there, and start multiplying. This is what we call `Infective Endocarditis`.
How does this situation affect your health?
If left untreated, these germs multiply on the heart valves, forming what look like germy growths. In medicine, we call these vegetations . These are just little growths that grow on the valves.
These germs produce enzymes that begin to destroy healthy heart valve tissue. This causes:
- Valve weakness: The valve may not close properly and blood may start to leak backward (leaky valve).
- Heart Failure: When the valves don't work properly, the heart can't pump blood as well as it should. This is not a heart attack, but a gradual weakening of the heart.
- Embolism: The most dangerous thing is that a small piece of one of those vegetations can break off and travel with the blood and block a blood vessel elsewhere in the body. We call this broken piece an embolus . If it gets stuck in a blood vessel in the brain, it can cause a stroke , and if it gets stuck in the lungs, it can cause a life-threatening condition called pulmonary embolism .
Treatment methods and the need for surgery
Treatment for this disease depends on the type of germ causing the infection and the severity of the disease. If detected early, the disease can be cured with a few weeks of strong antibiotics.
However, if vegetations have formed on the valves, if the valves are damaged, or if an artificial valve you already have becomes infected, surgery is often necessary.
What to expect from surgery:
- Complete elimination of uncontrolled infection.
- Repairing damage to the valves or removing the damaged valve and installing a new one.
- Preventing severe complications like paralysis.
When should the surgery be performed?
The timing of the surgery depends on the severity of your condition. Sometimes the surgery may need to be done sooner, while other times it may take a little longer. Let's take a look at what those situations are.
| Timing of Surgery | |
|---|---|
| Situations where emergency surgery may be required | |
| Reason | Description |
| Heart Failure | If the heart cannot pump blood properly due to damage to the valves. |
| Large Vegetations | There is a high risk of these pieces breaking off and causing an embolism. |
| Failure to respond to antibiotics | If the infection cannot be controlled even after antibiotics are given. |
| Prosthetic valve infection | If an existing prosthetic valve becomes infected. |
| Heart abscess | If the infection has caused things like abscesses in the heart muscle. |
| Delayed Surgery Cases | |
| Nervous system complications | If the patient has already had a condition such as a stroke, surgery may be postponed until the brain's condition stabilizes. |
| If the infection can be controlled | If the infection is not severe and the risk of complications is low, the surgery can be performed after a full course of antibiotics has been administered and the infection has cleared up. |
How do I know if surgery is right for me?
This is not a decision you make alone. Your doctor and a team of cardiologists make this decision together. They will perform several tests.
- Blood tests: Identify the exact type of bacteria or fungus causing the infection.
- Echocardiogram (TEE/TTE): This is like a scan of the heart. It can check for many things, such as the size of vegetations on the valves, damage to the valves, and whether there is any blood leakage.
- CT Scans: To check for complications in the brain or other organs.
What happens after the surgery? And what are the risks?
You will need to stay in the intensive care unit (ICU) for the first few days after surgery. Your heart function will be monitored. You will need to take antibiotics intravenously or in pill form for several weeks until the infection is completely gone. You should get plenty of rest after you go home. It is normal to feel tired and sore.
Like any major surgery, there are risks. These include excessive bleeding, irregular heartbeat (arrhythmia), blood clots, paralysis , and infection of the newly implanted valve. But remember, the risks of not having surgery are much greater. Your doctor will explain these risks to you.
When to see the doctor after surgery
It is very important to seek medical advice immediately if you experience any of the following symptoms after returning home.
- Chest pain or a feeling of tightness in the chest.
- Pus or unusual bleeding from the surgical wound.
- Redness, swelling, or warmth around the wound.
- If you feel feverish or have a cold.
- If you feel shortness of breath or your heart is beating fast (palpitations).
Infective Endocarditis is not a disease to be taken lightly. However, with the right treatment at the right time and, if necessary, surgery, many lives can be saved.
Take-Home Message
- Infective endocarditis is a serious infection caused by germs entering the heart valves. It requires immediate medical treatment.
- Although initially curable with antibiotics, surgery is often necessary when the valves are damaged or large vegetations develop.
- Surgery can control infection, preserve heart function, and prevent serious complications such as paralysis.
- The timing of the surgery is determined by a medical team based on your medical condition.
- It takes time to recover after surgery. Follow your doctor's instructions exactly and always be aware of warning signs. Talk to your doctor if you have any concerns.
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