Infective Endocarditis: Treatment, Procedure, Cost and Side Effects

Infective Endocarditis is also commonly referred to as IE. Other names it is known by include Subacute Bacterial Endocarditis (SBE) and Bacterial Endocarditis (BE).

Defined as the infection of the endocardial layer of the heart of the patient, Infective Endocarditis or IE is quite dangerous and can even lead to heart failure. The signs and symptoms of IE include a high fever, weight loss, altered heart murmur, splinter hemorrhages, night sweats, anemia and more. This type of infection is caused by several different types of microorganisms although certain type of bacteria are the most common cause. Fungal infections are very rare in the case of IE. Diagnosis of this infection is generally carried out with the help of ultrasound or testing of blood cultures. No matter what the cause maybe, IE is a type of infection that requires prompt treatment or the consequences can be fatal. Apart from heart failure, other complications associated with IE are kidney failure, stroke and valvular insufficiency (which is the flow of blood in the opposite direction). Commonly used treatment methods for IE include the intravenous administration of antibiotics and in rare cases, heart surgery. However, usually antibiotics prove to be enough and surgery is generally avoided as it can prove to be fatal.

The type of antibiotic used to treat IE is dependent on the blood culture obtained. Since antibiotics to treat IE are administered intravenously, the patient may have to visit the hospital or local clinic frequently to get their dose. If that is not possible, the patient may arrange for the administration of antibiotics at home. Intravenous methods of administering antibiotics include either an injection or the drip. In some cases, where antibiotics don't help in controlling the infection, the doctor may recommend going for a cardiovascular surgery. This surgery is mostly carried out in the early stages of infection. This type of surgery can be either open heart or minimally invasive. In an open heart surgery, the affected individual's heart is opened with the help of surgical instruments and the infection is removed. On the other hand, in the minimally invasive heart surgery, small incisions are made in the chest wall of the patient and the surgeon inserts an endoscope through the insertion to carry out the surgery. In both cases, general anesthesia is administered to the patient, which means the patient is unconscious throughout the whole procedure. In certain hospitals, this surgery may also be carried out with the help of robots assisting the surgeon. This reduces the size of the incision by a lot.

Medications are recommended for less severe cases of IE. As for surgery, only those patients are eligible who experience either one or more of the following- Congestive cardiac failure Systemic embolism Uncontrolled infection that spreads to other parts.

Patients who are very old and for whom surgery can prove to be fatal are not eligible for surgical procedures.

Antibiotics come with the usual side effects of nausea, dizziness, vomiting, constipation, headaches etc. Cardiovascular surgery has its own risks too, which are pain in the chest, muscle pain, swelling, loss of appetite, problems in sleeping, mood swings, depression, constipation etc.

Post-cardiac surgery, the patient will have to stay in the ICU for at least 48 hours, after which, he or she maybe discharged if there are no complications. After getting home, bed rest is strictly advised and the patient may also be asked to wear compressor socks to regulate the flow of the blood. Also, lifting of heavy weights, indulging in physically strenuous activities, driving as well as showering maybe prohibited for some time. Dietary restrictions may be imposed as well. There are no such guidelines for antibiotics.

It can take about 6 to 8 weeks to recover from the surgery carried out to treat infective endocarditis. If one opts for antibiotics, then it can take about 2 weeks to recover.

The cost of antibiotic injections that are used to treat IE range from Rs 7 to Rs 65. Cardiovascular surgeries are costly and can cost Rs 3 lakhs and upwards.

Both the treatment options are highly effective and chances of a recurrence of the infection are very low.