Endocarditis

Introduction:

Endocarditis is an inflammation of the endocardium, the membrane that covers connective tissue in heart valves and lines heart chambers. Most cases are caused by a bacterial infection. Endocarditis is a serious ailment that can lead to severe medical complications, and can even be fatal if not treated.

Signs and Symptoms:

The most common symptom of endocarditis is fever. The fever may be high or low, and it may seem to come and go. Other common symptoms include the following:

• Chills
• Muscle weakness
• Fatigue
• Muscle, joint, back pain
• Night sweats
• Shortness of breath
• Cough
• Unnatural pallor
• Weight loss
• Heart murmur
• Painful spleen or abdomen
• Bloody urine
• Stiff neck
• Seizures
• Heart attack
• Cold, painful hands and feet
• Painful tips of fingers or toes

What Causes It?:

Most causes of endocarditis are related to a bacterial infection. Usually your body fights off an infection, even if bacteria reach your heart. But when heart valves or tissue are damaged, they provide a good place for bacteria to lodge and multiply. Your risk of endocarditis increases if you have heart disease or mechanical heart valves. Procedures that increase your risk of endocarditis include dental procedures that irritate the gums, tonsillectomy, adenoidectomy, intestinal and respiratory surgery, gallbladder surgery, cystoscopy, bronchoscopy, and vaginal delivery with an infection present.

What to Expect at Your Provider's Office:

Your health care provider will listen to your heart and lungs, take your pulse, and check your eyes and skin. They likely will order several tests, which could include blood tests, urine analysis, an echocardiogram, a computed tomography (CT) scan, and a cinefluoroscopy (a motion-picture type heart scan). Usually, your provider will admit you to the hospital, possibly in intensive care, until your symptoms are under control.

Treatment Options:

Endocarditis is treated with high doses of antibiotics, almost always intravenously. Sometimes, surgery is also required.

Drug Therapies

Endocarditis is usually treated with a combination of two or three antibiotics such as penicillin, gentamicin, vancomycin, cefazolin, ceftriaxone, nafcillin, oxacillin, rifampin, and ampicillin. Treatment is determined by what type of bacteria is infecting your heart and generally takes 2 - 6 weeks.

Complementary and Alternative Therapies

Endocarditis has serious ramifications and requires aggressive medical treatment. Alternative therapies may be used concurrently to help reduce severity, duration, and progression of disease, but endocarditis should never be treated with alternative therapies alone. Inform all of your health care providers of any alternative medicine therapies or supplements you are using.

Nutrition

Following these nutritional tips may help reduce symptoms:

• Eliminate suspected food allergens, such as dairy (milk, cheese, and ice cream), wheat (gluten), soy, corn, preservatives, and chemical food additives. Your health care provider may want to test you for food allergies.
• Eat foods high in B-vitamins and iron, such as whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.
• Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell pepper).
• Avoid refined foods such as white breads, pastas, and sugar.
• Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy), or beans for protein.
• Use healthy oils in the diet, such as olive oil or vegetable oil.
• Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
• Avoid alcohol and tobacco.
• Exercise lightly, if possible, 5 days a week.

You may address nutritional deficiencies with the following supplements:

• A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc and selenium.
• Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 - 2 tbs. of oil daily, to help decrease inflammation and help with immunity.
• Vitamin C, 500 - 1,000 mg daily, as an antioxidant and immune support.
• Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support.
• Magnesium citrate, 200 - 400 mg daily, for heart health.
• Coenzyme Q10 (CoQ10), 100 mg twice a day, for heart protection.
• Resveratrol (from red wine), 50 - 200 mg daily, to help decrease inflammation and for antioxidant effects.
• Lycopene, 5 mg one to three times daily, for antioxidant and blood pressure lowering activity.
• L-theanine, 200 mg one to three times daily, for stress and nervous system support.
• L-arginine, 1 -2 gm three times daily, for blood vessel and immune support.
• Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, when needed for maintenance of gastrointestinal and immune health. Some acidophilus products may need refrigeration - check labels carefully.
• Grapefruit seed extract (Citrus paradisi), 100 mg capsule or 5 - 10 drops (in favorite beverage) three times daily when needed, for antibacterial, antifungal, and antiviral activity, and for immunity.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

• Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant and heart health effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
• Ginkgo (Ginkgo biloba) standardized extract, 40 - 80 mg three times daily, for antioxidant and heart health support.
• Reishi mushroom (Ganoderma lucidum), 150 - 300 mg two to three times daily, for blood pressure support. You may also take a tincture of this mushroom extract, 30 - 60 drops two to three times a day.
• Garlic (Allium sativum), standardized extract, 400 mg two to three times daily, for heart health.
• Fermented wheat germ extract, 1 packet dissolved in favorite beverage once daily, for immune support.

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies as a supplemental treatment for the symptoms of endocarditis as long as the underlying infection has been appropriately treated. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

• Aconite if you fear death, have rapid heartbeat (tachycardia) with full, hard bounding pulse of sudden onset.
• Cactus grandiflorus for endocarditis with mitral insufficiency. You may have a feeble, irregular pulse and feel a chest constriction.
• Digitalis if you have an irregular pulse with a sensation as if your heart would stop if you moved.
• Spongia if you have a sensation of the heart swelling.

Acupuncture

Acupuncture may help improve immunity and strengthen heart function.

Following Up:

In addition to monitoring your condition while you are in the hospital, your health care provider will order follow-up procedures, such as blood tests, to determine how well the prescribed treatment is working.

Alternative Names:

Heart infection - endocarditis