什么是心内膜炎？

Endocarditisis inflammation of your heart’s inner lining, called the endocardium. It’s usually caused by bacteria. When the inflammation is caused by infection, the condition is called infective endocarditis. Endocarditis is uncommon in people withhealthy hearts。

The symptoms of endocarditis aren’t always severe, and they may develop slowly over time. In the early stages of endocarditis, the symptoms are similar to many other illnesses. This is why many cases go undiagnosed.

Many of the symptoms are similar to cases of thefluor other infections, such aspneumonia。但是，有些人经历了突然出现的严重症状。这些症状可能是由于炎症或其造成的相关损害。

心内膜炎的常见症状包括：

Less common symptoms of endocarditis include:

皮肤的变化也可能发生，包括：

  • tender red or purple spots below the skin of fingers or toes
  • tiny red or purple spots from blood cells that leaked out of ruptured capillary vessels, which usually appear on the whites of the eyes, inside the cheeks, on the roof of the mouth, or on the chest

The signs and symptoms of infectious endocarditis vary greatly from person to person. They can change over time, and they depend on the cause of your infection, heart health, and how long the infection has been present. If you have a history of heart problems, heart surgery, or prior endocarditis, you should contact your doctor immediately if you have any of these symptoms. It’s especially important to contact your doctor if you have a constant fever that will not break or you’re unusually tired and don’t know why.

心内膜炎的主要原因是细菌的过度生长。尽管这些细菌通常生活在身体的内部或外部表面，但您可以通过进食或饮用将它们带入血液中。细菌也可以通过割伤您的皮肤或口腔进入。您的immune systemnormally fights off germs before they cause a problem, but this process fails in some people.

In the case of infective endocarditis, the germs travel through your bloodstream and into your heart, where they multiply and cause inflammation. Endocarditis can also be caused by fungi or other germs.

饮食并不是细菌进入身体的唯一方法。他们还可以通过：

Risk factors for developing endocarditis include the following:

  • injecting illicit intravenous drugs with a needle contaminated with bacteria or fungi
  • scarring caused by heart valve damage, which allows bacteria or germs to grow
  • tissue damage from having endocarditis in the past
  • 有心脏缺陷
  • having an人造心脏瓣膜replacement

您的医生将在进行任何检查之前详细介绍您的症状和病史。经过这次评论，他们将使用听诊器听取您的心。也可以进行以下测试：

Blood test

如果您的医生怀疑您患有心内膜炎，则blood culture test将被命令确认细菌，真菌或其他微生物是否引起了该细菌。其他血液检查也可以揭示您的症状是否是由其他疾病引起的，例如anemia。

Transthoracic echocardiogram

经胸腔echocardiogramis a non-radiating imaging test used to view your heart and its valves. This test usesultrasoundwaves to create an image of your heart, with the imaging probe placed on the front of your chest. Your doctor can use this imaging test to look for signs of damage or abnormal movements of your heart.

Transesophageal echocardiogram

When a transthoracic echocardiogram doesn’t provide enough information to assess your heart accurately, your doctor might order an additional imaging test called a transesophageal echocardiogram. This is used to view your heart by way of your esophagus.

心电图

Anelectrocardiogram（ECG或EKG）可以要求更好地了解您心脏的电动活动。该测试可以检测出异常的心律或速率。技术人员将在您的皮肤上附加12至15个软电极。这些电极连接到电线（电线）上，然后将其连接到心电机机器上。

Chest X-ray

Acollapsed lungor other lung problems can cause some of the same symptoms as endocarditis. Achest X-raymay be used to view your lungs and see if they’ve collapsed or if fluid has built up in them. A buildup of fluid is calledpulmonary edema。The X-ray can help your doctor tell the difference between endocarditis and other conditions involving with your lungs.

Antibiotics

If your endocarditis is caused by bacteria, it will be treated with intravenous antibiotic therapy. Your doctor will advise you to take antibiotics until your infection and related inflammation are effectively treated. You will likely receive these in a hospital for at least a week, until you show signs of improvement. You will need to continue antibiotic therapy upon discharge from the hospital. You may be able to transition to oral antibiotics later in your treatment. Antibiotic therapy typically takes up to 六个星期 to complete.

手术

长时间的感染性心内膜炎或心内膜炎引起的心脏瓣膜受损可能需要手术才能纠正。可以进行手术以去除受感染组织中的任何死组织，疤痕组织，液体堆积或碎屑。还可以进行手术以修复或去除受损的心脏瓣膜，并用人造材料或动物组织代替。

并发症may develop from damage caused by your infection. These can include an abnormal heart rhythm, such asatrial fibrillation,blood clots，其他器官损伤和高胆红素血症jaundice。Infected blood can also cause emboli, or clots, to travel to other parts of your body.

可能受到影响的其他器官包括：

  • 肾脏可能发炎，导致一种称为glomerulonephritis
  • lungs
  • brain
  • 骨骼，尤其是您的脊柱，可能被感染，导致骨髓炎

细菌或真菌可以从您的心脏循环并影响这些区域。这些细菌也可能导致您的器官或身体其他部位发育。

Additional severe complications that can arise from endocarditis include stroke and heart failure.

拥有良好的口腔卫生并进行定期牙科预约可以帮助降低细菌在口中积聚并进入血液的风险。这降低了您因口腔感染或损伤而出现心内膜炎的风险。如果您经过了接受抗生素随访的牙科治疗，请确保按照指示服用抗生素。

如果您有先天性心脏病的病史，心脏手术或心内膜炎，请注意心内膜炎的体征和症状。特别注意持续发烧和无法解释的疲劳。如果您有这些症状，请尽快与您的医生联系。

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