Infective endocarditis (IE) is a serious infection of the heart valves and endocardium caused by bacteria, fungi or other organisms. This life-threatening condition requires urgent diagnosis, aggressive antibiotic therapy and sometimes emergency surgical intervention. Livasa Hospital provides comprehensive endocarditis management integrating infectious disease expertise with cardiac specialties.

Understanding Infective Endocarditis

Endocarditis occurs when blood-borne pathogens lodge on heart valves and multiply, causing valve damage, formation of vegetations (infected clots) and systemic symptoms.

Risk factors include:

• Pre-existing valve disease (rheumatic, degenerative, prosthetic)

• Congenital heart defects

• Intravenous drug abuse

• Indwelling vascular catheters

• Poor dental hygiene and dental procedures

• Immunosuppression

Classification

• Native valve endocarditis – Infection of normal or abnormal native valves

• Prosthetic valve endocarditis – Infection of surgically implanted valves

• Right-sided endocarditis – Associated with IV drug abuse

Clinical Presentation

Symptoms are often non-specific:

• Fever – Usually present but may be low-grade

• Heart murmur – Often new or changing

• Malaise and fatigue – General systemic symptoms

• Weight loss – Chronic illness effects

• Joint pain – From immune complex deposition

• Embolic phenomena – Stroke, pulmonary embolism, splinter haemorrhages

• Heart failure – From valve destruction

Diagnostic Evaluation

Blood cultures:

• Multiple blood cultures before antibiotic initiation

• Gold-standard for organism identification

Echocardiography:

• Transthoracic echocardiogram – Initial imaging

• Transoesophageal echocardiogram – Superior sensitivity for vegetations and complications

Diagnostic criteria (Duke criteria):

• Combines clinical, microbiology and echocardiographic findings

Treatment Approach

Antibiotic Therapy:

• Empirical broad-spectrum antibiotics pending culture results

• Culture-directed therapy once organism identified

• Typically 4–6 weeks intravenous antibiotics

• Combination therapy for optimal bacterial killing

Supportive Care:

• Haemodynamic monitoring

• Management of complications

• Heart failure management if present

Surgical Intervention:

• Indicated for:

  • Large vegetations at risk of embolism

  • Prosthetic valve endocarditis

  • Valve destruction with severe regurgitation

  • Abscess formation

  • Septic emboli

  • Failed medical therapy

Surgical Management

When indicated, valve repair or replacement is performed:

• Removal of infected tissue and vegetations

• Valve repair when feasible

• Prosthetic replacement if necessary

Complications

Serious complications include:

• Septic embolism – Infection spread to other organs

• Valve destruction – Progressive regurgitation and heart failure

• Abscess formation – Localised pus collections requiring surgical drainage

• Mechanical failure – Prosthetic valve dysfunction

• Septic shock – Severe systemic infection response

Prevention Strategies

Risk reduction includes:

• Antibiotic prophylaxis – For at-risk patients undergoing invasive procedures

• Good dental hygiene – Reduce bacteraemia from dental disease

• Wound care – Proper management of cuts and infections

• Safe practices – Sterile technique for IV access

Why Choose Livasa Hospital?

• Integrated cardiology and infectious disease expertise

• Rapid echocardiographic assessment

• 24x7 surgical capability for emergency procedures

• Comprehensive supportive care and ICU resources

NAP – Contact Details

Livasa Hospital Mohali
Sector 71, Sahibzada Ajit Singh Nagar (SAS Nagar)
Mohali, Punjab – 160071
Phone: +91-80788 80788 (24/7 Emergency)
Website: www.livasahospitals.com

If you suspect endocarditis, call +91-80788 80788 for emergency evaluation.