Coronary artery disease occurs when the blood vessels supplying the heart with oxygen-rich blood become narrowed or blocked due to a buildup of fatty deposits (plaques). This restricts blood flow to the heart and can lead to chest pain (angina) or heart attacks.

Symptoms

Chest pain: Tightness, pressure, or squeezing sensation in the chest, often triggered by physical activity or stress.

Shortness of breath: Difficulty breathing during exertion or rest.

Fatigue: Feeling unusually tired or weak, especially during physical activity.

Heart attack symptoms: Sudden, severe chest pain, nausea, sweating, pain radiating to the arms, jaw, or back.

Risk Factors

Smoking

Poor diet

Physical inactivity

Excessive alcohol consumption

High blood pressure

High cholesterol

Diabetes

Obesity or metabolic syndrome

Family history of heart disease

Age (higher risk in men over 45 and women over 55)

Stress

Diagnosis

Medical history and physical examination: Understanding symptoms, family history, and risk factors.

Electrocardiogram (ECG): Detects abnormal heart rhythms or signs of past heart attacks.

Stress tests: Evaluates heart function during physical activity or with medication.

Echocardiogram: Uses ultrasound to visualize heart structure and function.

Coronary angiography: A dye and X-rays are used to detect blockages in coronary arteries.

Blood tests: Measures cholesterol levels, blood sugar, and markers of heart damage.

CT or MRI scans: Provides detailed images of the heart and arteries.

Treatment Options

Statins: To lower cholesterol.

Antiplatelet drugs (e.g., aspirin): To prevent blood clots.

Beta-blockers: To reduce heart rate and blood pressure.

ACE inhibitors or ARBs: To lower blood pressure and protect heart function.

Nitroglycerin: For relieving chest pain (angina).

Angioplasty and stenting: Opens blocked arteries using a balloon and places a stent to keep them open.

Coronary artery bypass grafting (CABG): Surgery that creates new routes for blood to flow around blocked arteries.

Enhanced external counterpulsation (EECP): A non-invasive treatment for improving blood flow.

A heart attack occurs when one of the coronary arteries becomes blocked, cutting off the blood supply to part of the heart muscle. This leads to the damage or death of heart tissue.

Symptoms

Chest pain or discomfort: A feeling of pressure, tightness, or squeezing in the center or left side of the chest.

Pain in other areas: Discomfort may radiate to the arms, shoulders, back, neck, jaw, or stomach.

Shortness of breath: Difficulty breathing, even at rest.

Nausea or vomiting.

Cold sweat: Profuse sweating unrelated to heat or activity.

Lightheadedness or dizziness.

Fatigue: Unusual tiredness, particularly in women.

Risk Factors

Smoking

Unhealthy diet (high in trans fats, cholesterol, and sodium)

Sedentary lifestyle

Excessive alcohol consumption

High blood pressure (hypertension)

High cholesterol (especially high LDL and low HDL)

Diabetes

Obesity or metabolic syndrome

Age (risk increases for men over 45 and women over 55)

Family history of heart disease

Stress or depression

Illicit drug use (e.g., cocaine, methamphetamine)

Diagnosis

Electrocardiogram (ECG): Detects abnormal heart rhythms and signs of heart muscle damage.

Blood tests: Measures cardiac enzymes like troponin, which are released during a heart attack.

Coronary angiography: Uses dye and X-rays to visualize blockages in the coronary arteries.

Echocardiogram: Assesses heart function and areas of damage.

CT or MRI scans: Provides detailed imaging of the heart and blood vessels.

Treatment Options

Thrombolytics (clot-busting drugs) to dissolve blood clots

Antiplatelet drugs (e.g., aspirin) to prevent further clotting

Nitroglycerin to improve blood flow

Pain relievers for chest discomfort

Percutaneous coronary intervention (PCI): Angioplasty with stenting to reopen blocked arteries.

Coronary artery bypass grafting (CABG): Surgery to create new pathways for blood to flow around blocked arteries.

Heart failure is a condition where the heart cannot pump blood effectively, leading to insufficient blood supply to the body’s organs and tissues.

Symptoms

Shortness of breath: Occurs during activity or while lying flat, often accompanied by waking up feeling breathless.

Fatigue and weakness: Persistent tiredness and reduced ability to perform physical activities.

Swelling (Edema): In the legs, ankles, feet, and abdomen due to fluid retention.

Rapid or irregular heartbeat: Palpitations or fluttering in the chest.

Persistent cough or wheezing: Often producing white or pink-tinged mucus.

Increased need to urinate at night.

Difficulty concentrating or confusion: Caused by reduced blood flow to the brain.

Weight gain: Due to fluid buildup.

Risk Factors

Coronary artery disease (CAD) or history of heart attack

High blood pressure (hypertension)

Diabetes

Valvular heart disease

Cardiomyopathy (heart muscle disease)

Smoking

Unhealthy diet high in sodium and fat

Lack of physical activity

Excessive alcohol consumption or drug use

Age (risk increases with age)

Family history of heart failure or heart diseases

Obesity

Sleep apnea

Diagnosis

Medical history and physical examination: Checks for symptoms and underlying conditions.

Blood tests: Measures B-type natriuretic peptide (BNP) levels, which are elevated in heart failure.

Chest X-ray: Detects fluid in the lungs and changes in heart size.

Electrocardiogram (ECG): Identifies abnormal heart rhythms or past heart attacks.

Echocardiogram: Visualizes heart structure and function, including ejection fraction (EF), which measures how well the heart pumps blood.

Stress test: Evaluates heart function during physical exertion.

Coronary angiography: Checks for blockages in the coronary arteries.

Cardiac MRI or CT scan: Provides detailed images of the heart.

Treatment Options

Diuretics: To reduce fluid buildup and swelling.

ACE inhibitors or ARBs: To relax blood vessels and improve heart efficiency.

Beta-blockers: To slow heart rate and reduce workload.

Aldosterone antagonists: To lower blood pressure and fluid retention.

Digoxin: To strengthen heart contractions.

SGLT2 inhibitors: To improve outcomes in certain types of heart failure.

Implantable cardioverter-defibrillator (ICD): Prevents sudden cardiac arrest.

Cardiac resynchronization therapy (CRT): Improves heart rhythm and function.

Left ventricular assist device (LVAD): Supports heart pumping in severe cases.

Coronary artery bypass grafting (CABG): Treats blocked arteries.

Valve repair or replacement: For faulty heart valves.

Heart transplant: Considered in end-stage heart failure when other treatments are ineffective.

Arrhythmia refers to abnormal heart rhythms. The heart may beat too fast (tachycardia), too slow (bradycardia), or irregularly. Some arrhythmias are harmless, while others can be life-threatening.

Symptoms

Palpitations: A feeling of fluttering or a racing heart.

Shortness of breath: Difficulty breathing, especially during exertion.

Dizziness or lightheadedness.

Fainting (syncope): Temporary loss of consciousness.

Fatigue: Persistent tiredness even with adequate rest.

Chest pain or discomfort: Particularly in serious arrhythmias.

Weakness: Generalized feeling of being unwell.

Risk Factors

Coronary artery disease

Heart failure

Previous heart attack

Structural heart defects

High blood pressure (hypertension)

Diabetes

Thyroid imbalances (hyperthyroidism or hypothyroidism)

Sleep apnea

Smoking

Excessive alcohol or caffeine consumption

Stress or anxiety

Use of certain drugs (e.g., stimulants, beta-agonists)

Older age

Family history of arrhythmias or heart conditions

Diagnosis

Medical history and physical exam: Includes checking for pulse irregularities and listening to the heart.

Electrocardiogram (ECG): A primary tool to detect abnormal heart rhythms.

Holter monitor: A portable ECG worn for 24-48 hours to monitor heart activity.

Event recorder: Worn for weeks to capture irregularities when symptoms occur.

Echocardiogram: Ultrasound imaging to assess heart structure and function.

Stress test: Evaluates the heart's rhythm during physical exertion.

Electrophysiological study (EPS): Maps electrical activity in the heart to locate abnormal pathways.

Blood tests: To check for electrolyte imbalances or thyroid problems.

Treatment Options

Antiarrhythmic drugs: To restore normal rhythm.

Beta-blockers: To control heart rate.

Calcium channel blockers: For certain arrhythmias.

Anticoagulants or antiplatelet drugs: To prevent blood clots, especially in atrial fibrillation.

Cardioversion: Electrical shocks to reset heart rhythm.

Catheter ablation: Destroys abnormal electrical pathways causing arrhythmia.

Pacemaker: Implanted device to regulate slow heartbeats.

Implantable cardioverter-defibrillator (ICD): For life-threatening arrhythmias.

Maze procedure: Creates scar tissue to disrupt abnormal signals.

Corrective surgery: For structural heart issues contributing to arrhythmias.

Hypertension is a condition where the force of the blood against the artery walls is consistently too high. Over time, this can lead to heart disease, stroke, kidney damage, and other complications.

Symptoms

Most people with hypertension have no symptoms, even at dangerously high levels. However, symptoms that may occur include:

Headaches: Usually in severe or hypertensive crisis cases.

Shortness of breath.

Nosebleeds: Rare and typically during a hypertensive emergency.

Blurred or double vision.

Dizziness or lightheadedness.

Chest pain: May signal complications.

These symptoms often indicate a severe or secondary condition rather than primary hypertension.

Risk Factors

High salt (sodium) intake

Excessive alcohol consumption

Smoking or tobacco use

Sedentary lifestyle

Unhealthy diet (low in fruits and vegetables)

Obesity or overweight

Diabetes

Chronic kidney disease

Sleep apnea

Family history of hypertension

Age

Ethnicity (e.g., African Americans are at higher risk).

Gender (men are more prone before age 65; women after).

Stress

Diagnosis

Ambulatory blood pressure monitoring: Measures BP over 24 hours.

Blood tests: Check for kidney function, cholesterol, and diabetes.

Urine tests: Look for kidney-related issues.

Electrocardiogram (ECG): Detects heart abnormalities.

Echocardiogram: Assesses heart structure and function.

Treatment Options

Diuretics: Help eliminate excess sodium and water.

ACE inhibitors: Relax blood vessels.

ARBs (Angiotensin II receptor blockers): Prevent blood vessel narrowing.

Calcium channel blockers: Relax blood vessel muscles.

Beta-blockers: Reduce heart rate and workload.

Renin inhibitors: Lower blood pressure by decreasing renin production.

Valvular heart disease occurs when one or more of the heart’s valves (mitral, aortic, tricuspid, or pulmonary) do not function properly, either due to narrowing (stenosis) or leaking (regurgitation). This can interfere with normal blood flow through the heart.

Symptoms

Symptoms depend on the severity and type of valvular dysfunction but may include:

Shortness of breath: Especially during physical activity or when lying flat.

Fatigue: Persistent tiredness due to reduced blood circulation.

Chest pain or discomfort: Especially in aortic valve disease.

Palpitations: Feeling of a racing or irregular heartbeat.

Swelling: In the ankles, feet, or abdomen (edema).

Dizziness or fainting: Often seen in aortic stenosis.

Heart murmur: An abnormal sound heard through a stethoscope.

Risk Factors

High blood pressure (hypertension)

Atherosclerosis (plaque buildup in arteries)

Autoimmune diseases (e.g., lupus, rheumatoid arthritis)

Smoking

Older age

Family history of heart disease

Diagnosis

Echocardiogram: Primary imaging tool to evaluate valve structure and function.

Electrocardiogram (ECG): Detects abnormal heart rhythms and enlargement.

Chest X-ray: Looks for heart enlargement or fluid in the lungs.

Cardiac MRI: Provides detailed images of heart valves and chambers.

Stress tests: Assess valve function during physical activity.

Cardiac catheterization: Measures pressure within heart chambers and evaluates blood flow.

Treatment Options

Diuretics: Reduce fluid buildup.

Beta-blockers: Control heart rate and blood pressure.

ACE inhibitors or ARBs: Improve blood flow and reduce heart strain.

Anticoagulants: Prevent blood clots in cases of valve-related atrial fibrillation.

Valve Repair: Fixing the valve to improve function.

Techniques include reshaping, patching holes, or reinforcing structures.

Mechanical valves: Durable but require lifelong anticoagulation.

Biological valves: Made from animal or human tissue; less durable than mechanical.

Balloon Valvuloplasty: Minimally invasive procedure to widen a narrowed valve (e.g., in stenosis).

Transcatheter Aortic Valve Replacement (TAVR): Less invasive replacement option for aortic stenosis.

Atrial fibrillation is a type of arrhythmia characterized by rapid and irregular beating of the heart's upper chambers (atria). It increases the risk of stroke and other heart-related complications.

Symptoms

AFib symptoms can vary and may be intermittent (paroxysmal), persistent, or long-standing. Common symptoms include:

Heart palpitations: Rapid, fluttering, or pounding heartbeat.

Fatigue: Often sudden or unexplained.

Shortness of breath: Especially during activity or when lying flat.

Chest discomfort or pain.

Dizziness or lightheadedness.

Weakness or reduced exercise capacity.

Fainting (syncope): Rare but possible.

No symptoms: Some individuals are asymptomatic, making diagnosis challenging.

Risk Factors

High blood pressure (hypertension)

Coronary artery disease

Heart failure or prior heart attacks

Valvular heart disease

Congenital heart defects

Thyroid disorders (hyperthyroidism)

Sleep apnea

Diabetes

Excessive alcohol or caffeine intake

Smoking or tobacco use

Obesity or sedentary lifestyle

Old age (risk increases significantly after 60).

Family history of AFib.

Stress or significant emotional triggers

Post-surgical state (e.g., heart or lung surgeries)

Infections, especially pneumonia or pericarditis

Diagnosis

Electrocardiogram (ECG): The primary test for diagnosing AFib.

Holter monitor: Continuous ECG recording for 24-48 hours to detect intermittent AFib.

Event monitor: Used for longer periods when symptoms are sporadic.

Echocardiogram: Assesses heart structure and function.

Blood tests: Check for thyroid issues, electrolyte imbalances, and other underlying causes.

Chest X-ray: To rule out lung-related causes of symptoms.

Stress test: Evaluates heart function during physical exertion.

Treatment Options

Rate control medications: Beta-blockers (e.g., metoprolol), calcium channel blockers (e.g., diltiazem), or digoxin to slow heart rate.

Rhythm control medications: Antiarrhythmics (e.g., amiodarone, flecainide) to maintain normal rhythm.

Anticoagulants: Prevent blood clots and reduce stroke risk (e.g., warfarin, dabigatran, apixaban, or rivaroxaban).

Cardioversion: Electrical or medication-based to reset the heart’s rhythm.

Catheter ablation: Minimally invasive procedure to destroy areas of the heart causing abnormal signals.

Maze procedure: Surgical intervention creating scar tissue to block irregular electrical signals.

Left atrial appendage closure: Prevents blood clots in patients unable to take anticoagulants.

Implantable Devices:

Pacemaker: Helps maintain regular heartbeats if bradycardia (slow heart rate) coexists with AFib.

PAD occurs when the arteries that supply blood to the limbs (usually the legs) become narrowed or blocked by atherosclerosis. It is a form of peripheral vascular disease and can cause pain or cramping in the legs.

Peripheral artery disease (PAD) is a circulatory condition caused by the narrowing or blockage of arteries, typically in the legs, due to atherosclerosis (plaque buildup). It reduces blood flow to the extremities, often leading to pain, difficulty walking, and, in severe cases, tissue damage or limb loss.

Symptoms

Many individuals with PAD are asymptomatic, but common symptoms include:

Intermittent claudication: Pain, cramping, or muscle fatigue in the legs or hips during walking or exercise, relieved by rest.

Coldness in the lower leg or foot: Especially on one side.

Numbness or weakness in the legs.

Slow-healing sores or ulcers: On toes, feet, or legs.

Shiny skin or loss of hair on legs and feet.

Weak or absent pulse in the legs or feet.

Discoloration of the legs or feet: May appear pale or bluish.

Severe pain in the legs or feet at rest: Indicative of advanced PAD.

Risk Factors

Atherosclerosis

Diabetes

High blood pressure (hypertension)

High cholesterol

Smoking

Obesity

Sedentary lifestyle

Age

Family history of PAD, heart disease, or stroke.

Chronic kidney disease

Inflammatory conditions (e.g., lupus, rheumatoid arthritis)

Diagnosis

Medical History and Physical Examination: Evaluating symptoms and risk factors.

Ankle-brachial index (ABI): Compares blood pressure in the ankle and arm to detect blockages.

Ultrasound: Evaluates blood flow in arteries.

Angiography: Uses contrast dye and imaging (X-ray, MRI, or CT) to visualize arterial blockages.

Blood tests: Assess cholesterol, blood sugar, and inflammatory markers.

Treatment Options

Antiplatelet agents: Aspirin or clopidogrel to prevent blood clots.

Cholesterol-lowering drugs: Statins to reduce plaque buildup.

Blood pressure medications: ACE inhibitors or ARBs to manage hypertension.

Medications to improve blood flow: Cilostazol or pentoxifylline to reduce claudication symptoms.

Angioplasty and stenting: Opens narrowed arteries and supports them with a stent.

Atherectomy: Removes plaque buildup from artery walls.

Bypass surgery: Redirects blood flow around blocked arteries using a graft.

Amputation: For severe cases where tissue death cannot be reversed.

Cardiomyopathy refers to diseases of the heart muscle that impair the heart's ability to pump blood. It can lead to heart failure and arrhythmias.

Symptoms

Symptoms can vary depending on the type and severity but may include:

Shortness of breath: Especially during physical activity or when lying down.

Fatigue: Generalized and persistent.

Swelling: In the legs, ankles, feet, or abdomen (edema).

Chest pain or discomfort: Can occur during exertion or rest.

Palpitations: Sensation of rapid, pounding, or fluttering heartbeats.

Fainting or dizziness: Particularly during physical activity or stress.

Coughing or wheezing: Especially when lying flat, due to fluid buildup in the lungs.

Risk Factors

Family history of cardiomyopathy or sudden cardiac arrest

Coronary artery disease or prior heart attack

High blood pressure (hypertension)

Metabolic disorders, including diabetes or thyroid diseases

Autoimmune conditions

Viral infections affecting the heart (myocarditis).

Long-term alcohol or drug abuse

Poor diet or obesity

Sedentary lifestyle

Age

Chemotherapy or radiation therapy to the chest

Diagnosis

Medical History and Physical Examination: Evaluating symptoms and family history of heart conditions.

Electrocardiogram (ECG): Identifies irregular heart rhythms or electrical problems.

Echocardiogram: Visualizes heart size, shape, and function.

Cardiac MRI: Provides detailed images of the heart's structure.

Chest X-ray: Detects an enlarged heart or fluid in the lungs.

Stress test: Assesses heart function during exercise.

Cardiac catheterization and angiography: Examines blood flow and measures pressures in the heart.

Blood tests: Detect underlying causes, such as infections or metabolic disorders.

Genetic testing: Determines inherited forms of cardiomyopathy.

Treatment Options

ACE inhibitors or ARBs: Reduce heart strain and improve blood flow.

Beta-blockers: Lower heart rate and blood pressure.

Diuretics: Reduce fluid buildup in the body.

Aldosterone antagonists: Manage heart failure symptoms.

Antiarrhythmics: Control irregular heartbeats.

Anticoagulants: Prevent blood clots in patients at risk.

Pacemakers: Help regulate slow or abnormal heartbeats.

Implantable cardioverter-defibrillators (ICDs): Prevent sudden cardiac arrest.

Left ventricular assist devices (LVADs): Support weakened hearts.

Septal myectomy: Removes thickened heart muscle in hypertrophic cardiomyopathy.

Heart transplant: For severe cases when other treatments fail.

Alcohol septal ablation: Destroys part of the thickened heart muscle in hypertrophic cardiomyopathy.

Pericarditis is the inflammation of the pericardium, the sac-like membrane surrounding the heart. It can be caused by infections, autoimmune diseases, or heart attacks.

Symptoms

Chest pain: Sharp, stabbing, or burning pain, often worsening when lying down, breathing deeply, or coughing. Improves when sitting up or leaning forward.

Shortness of breath: Especially when reclining.

Fever: May accompany infection-related cases.

Heart palpitations: Sensation of a racing or fluttering heartbeat.

Fatigue and weakness: Generalized and persistent.

Swelling: In the abdomen, legs, or feet in severe cases.

Cough: Non-productive or dry.

Risk Factors

Viral infections (e.g., coxsackievirus, echovirus)

Bacterial infections (e.g., tuberculosis, staphylococcus)

Fungal infections (rare but possible)

Autoimmune diseases (e.g., lupus, rheumatoid arthritis)

Kidney failure (uremic pericarditis)

Cancer or its treatment (radiation or chemotherapy)

Injury to the chest (e.g., from an accident or surgery)

Complications from medical procedures, such as cardiac surgery

Recent heart attack (Dressler’s syndrome)

Use of certain medications (e.g., hydralazine, isoniazid)

Metabolic disorders (e.g., hypothyroidism)

Diagnosis

Medical History and Physical Examination: Listening for a pericardial rub (scratchy sound heard with a stethoscope).

Electrocardiogram (ECG): Detects changes in heart rhythms or inflammation patterns.

Echocardiogram: Visualizes fluid around the heart or thickening of the pericardium.

Chest X-ray: Identifies an enlarged heart or other abnormalities.

Cardiac MRI or CT scan: Provides detailed imaging of the pericardium.

Blood tests: Check for infection, inflammation markers (CRP, ESR), or specific causes (e.g., autoimmune diseases).

Pericardiocentesis: Sampling and testing pericardial fluid for infections or malignancy.

Treatment Options

Nonsteroidal anti-inflammatory drugs (NSAIDs): Such as ibuprofen or aspirin to reduce pain and inflammation.

Colchicine: To prevent recurrence and manage inflammation.

Corticosteroids: For severe inflammation, especially in autoimmune-related cases.

Antibiotics or antifungals: If an infection is identified as the cause.

Diuretics: To manage fluid buildup in severe cases.

Pericardiocentesis: Draining excess fluid in cases of pericardial effusion or tamponade.

Pericardiectomy: Surgical removal of part or all of the pericardium for chronic or constrictive pericarditis.

Congenital heart disease refers to heart defects that are present at birth. These defects can involve the heart's walls, valves, or blood vessels.

Symptoms

Symptoms vary depending on the type and severity of the defect but can include:

Cyanosis: Bluish tint to the skin, lips, or nails due to low oxygen levels in the blood.

Fatigue or weakness: Difficulty in exertion, such as during physical activity.

Shortness of breath: Especially with exertion or when lying flat.

Swelling: In the legs, ankles, or abdomen.

Poor feeding and growth: In infants, may be due to decreased oxygen supply or difficulty feeding.

Heart murmur: An abnormal sound heard through a stethoscope.

Rapid or irregular heartbeats: Often felt as palpitations.

Chest pain or discomfort: Especially during physical activity.

Frequent respiratory infections: Due to compromised heart function and oxygen levels.

Risk Factors

Family history of heart defects increases the risk

Certain genetic syndromes (e.g., Down syndrome, Turner syndrome) are associated with higher incidence of CHD

Infections during pregnancy

Poor maternal nutrition

Alcohol consumption or drug use

Diabetes

Obesity

Advanced maternal age

Exposure to harmful chemicals or medications

Radiation exposure

Premature birth: Babies born before 37 weeks may be at higher risk of heart defects.

Diagnosis

Medical History and Physical Examination: Review of family history, maternal health, and symptoms.

Echocardiogram: The most common test for diagnosing CHD, providing real-time images of the heart’s structure.

Electrocardiogram (ECG): Measures electrical activity to detect arrhythmias or other heart issues.

Chest X-ray: Visualizes heart size and lung condition, especially for more severe defects.

Cardiac MRI or CT scan: Provides detailed images of heart structure.

Fetal echocardiography: A specialized ultrasound performed during pregnancy to detect heart defects in the fetus.

Genetic testing: Can identify genetic conditions or syndromes associated with CHD.

Pulse oximetry: Measures oxygen levels in the blood, helping identify cyanosis or abnormal oxygenation.

Treatment Options

Diuretics: Help reduce fluid buildup in the lungs and body.

ACE inhibitors or ARBs: Help relax blood vessels and reduce strain on the heart.

Beta-blockers: Slow the heart rate and improve heart function.

Blood thinners: For those at risk of blood clots.

Cardiac catheterization: A thin tube inserted into the heart through a blood vessel to repair certain defects or improve blood flow.

Balloon angioplasty or valvuloplasty: Used to widen narrowed arteries or valves.

Open-heart surgery: Common for repairing larger defects, such as septal defects (holes in the heart walls), valve replacements, or complex structural abnormalities.

Heart transplant: In severe cases of heart failure caused by CHD, a heart transplant may be required.

Artificial heart valves: For those with valve defects that cannot be repaired.

Endocarditis is an infection of the inner lining of the heart, typically affecting the heart valves. It is often caused by bacteria entering the bloodstream and infecting the heart.

Symptoms

The symptoms of endocarditis can develop gradually or suddenly, depending on the severity and cause of the infection. Common symptoms include:

Fever: Often accompanied by chills and sweating.

Fatigue or weakness: Feeling tired or weak, even with minimal exertion.

Heart murmur: An abnormal sound heard by a doctor using a stethoscope, due to turbulent blood flow.

Shortness of breath: Difficulty breathing, especially when lying down.

Swelling: In the feet, legs, or abdomen.

Painful joints or muscles: Aches or pain in the joints.

Skin changes:

Petechiae: Small, red or purple spots on the skin, inside the mouth, or in the eyes.

Osler’s nodes: Painful, red nodules on fingers or toes.

Janeway lesions: Painless, flat lesions on the palms or soles.

Coughing or chest pain: Especially if the infection spreads to the lungs.

Weight loss and loss of appetite: Due to prolonged infection.

Night sweats: Heavy sweating during the night, even when not physically active.

Risk Factors

Congenital heart defects: Including valve problems or holes in the heart.

Heart valve replacements: Artificial heart valves are more prone to infection.

Previous endocarditis: A history of endocarditis increases the risk of recurrence.

Intravenous (IV) Drug Use: Sharing needles or using unsterile needles increases the likelihood of bacterial introduction into the bloodstream.

Implanted medical devices: Including pacemakers or defibrillators, as these provide surfaces for bacteria to attach to.

Age: Older adults are more likely to have conditions that make them vulnerable to endocarditis, such as weakened valves.

Weakened Immune System: Conditions like diabetes, HIV/AIDS, or immunosuppressive medications can impair the body's ability to fight infections.

Poor Oral Hygiene: Gum disease, dental procedures, or poor oral hygiene can allow bacteria from the mouth to enter the bloodstream and reach the heart.

Healthcare-Associated Infections: Having certain medical procedures (such as catheter insertion or surgeries) can increase the risk of bacteria entering the bloodstream.

Diagnosis

Medical History and Physical Examination: A doctor will assess risk factors, perform a physical examination, and listen for heart murmurs or signs of infection.

Blood Cultures: A key test, blood cultures help identify the bacteria or fungi causing the infection. Multiple blood samples are typically taken from different sites to ensure accuracy.

Echocardiogram: An ultrasound of the heart that can identify vegetations (masses of infection) on the heart valves or endocardial surface.

Electrocardiogram (ECG): This test measures the heart's electrical activity and can help identify any abnormal heart rhythms that result from the infection.

Chest X-ray: To look for signs of infection spreading to the lungs or heart enlargement.

CT or MRI scans: These may be used if there are concerns that the infection has spread to other areas of the body, such as the brain or kidneys.

Blood Tests: To assess the general condition of the body, including white blood cell count, which may indicate infection.

Urinalysis: Can identify signs of infection or emboli (clots that may have traveled from the heart).

Treatment Options

Intravenous (IV) antibiotics: The primary treatment for bacterial endocarditis. The specific antibiotic depends on the type of bacteria identified in the blood cultures. Treatment typically lasts 4-6 weeks.

Oral antibiotics: In some cases, after an initial IV course, patients may switch to oral antibiotics for the remainder of their treatment.

Antifungal therapy: If the infection is caused by fungi, antifungal medications are used.

Prophylactic antibiotics: For people at high risk, antibiotics may be given before dental or certain medical procedures to prevent infection.

Valve repair or replacement: If the heart valve is damaged and can't function properly, it may need to be surgically repaired or replaced.

Draining abscesses: If infection spreads and forms abscesses within the heart, draining these abscesses may be necessary.

Removal of infected devices or tissue: If a pacemaker or other implanted device is infected, it may need to be removed or replaced.