With endocarditis inflammation of the inner shell of the heart - endocardium. The endocardium lays the heart chambers, providing smoothness and elasticity of the inner chambers. Often this disease does not occur in isolation, but is combined with myocarditis (inflammation of the muscular membrane of the heart) or pericarditis (inflammation of the external wall of the heart). Also endocarditis often acts as a consequence of another, basic, disease.
Classification of endocarditis
Endocarditis in origin (etiology) is divided into two large groups:
- Infectious (septic) - is caused by damage to the inner shell of the heart by various microorganisms (bacterial, viral, fungal endocarditis, etc.).
- Non - infectious - arises as a reaction to metabolic disorders, cardiac trauma or the development of the immunopathological process (rheumatic endocarditis, endocarditis in connective tissue diseases, non-bacterial thrombotic endocarditis, Leffler's eosinophilic fibroelastic endocarditis, etc.).
Symptoms of endocarditis of various origins
Consider how some common forms of the disease manifest themselves.
Infective endocarditis
Symptoms (signs) of bacterial endocarditis, also called subacute septic, do not differ from the symptoms of the infectious form of the disease caused by other microorganisms. As a rule, they manifest themselves two weeks after infection. The onset of the disease can be either distinct or erased.
Most often, the disease occurs with a sharp increase in body temperature to 38.5 - 39.5 ° C, accompanied by chills and increased sweating. Then there are such signs as:
- joint and muscle pain ;
- weakness;
- decreased body weight;
- blanching of the skin (usually with a gray tinge);
- skin rash;
- small hemorrhages in the mucous membranes, etc.
In the future, the development of the disease leads to the appearance of the symptom of "tympanic fingers" - the terminal phalanges of the fingers and toes thicken, acquiring the appearance of tympanic sticks, and the nails - glasses of wristwatches.
Rheumatic endocarditis
This type of disease, as a rule, begins to appear during the first or second attack of articular phenomena with rheumatism. The most frequent complaints characterizing rheumatic endocarditis are:
- cardiopalmus;
- pain in the heart of varying severity;
- general malaise;
- an increase in body temperature, a persistent long period.
Leffler Endocarditis
In the initial stages, Leffler's endocarditis has no clinical manifestations. The patient can only observe the symptoms of the underlying disease, which caused severe eosinophilia (systemic connective tissue diseases, tumors, leukemias, etc.). When the disease progresses, its typical signs are:
- loss of body weight;
- fever;
- cough;
- skin rash.
Over time, chronic heart failure develops.
Diagnosis of endocarditis
Endocarditis is difficult to diagnose because of the variety of initial symptoms of the disease, the variety of damage to the heart tissue, and the presence of non-cardiac manifestations. The complex of measures for diagnosing includes: electrocardiography, echocardiography, blood tests (general, biochemical, immunological). More accurate diagnosis is carried out using magnetic resonance imaging of the heart. The effectiveness of treatment largely depends on the correct diagnosis (detection of the form of the disease).