Heart Infections

and close properly and may cause blood to "regurgitate" back into the area of the heart it was destined to leave. This can produce a whole range of complications ranging from the development of arrythmias to the onset of congestive heart failure. In addition, pieces of vegetation can break off and produce emboli, which have the potential to damage organs such as the lungs, kidneys or brain (producing a stroke).

Subacute endocarditis may be contracted by high risk individuals via simple hygenic techniques such as tooth brushing or certain types of dental work. This is because subactute endocarditis is caused by strains of the streptoccocus bacteria which normally live in the mouth. Hence, even slight injury to the mouth may introduce the bacteria into the bloodstream. This disease may also be caused by enterococcus, an organism commonly found in the gastrointestinal and urinary tracts. For this reason, high risk individuals (as will be defined below) must be treated with a careful regimen of preventative antibiotic prophylaxis before undergoing certain dental, gynecolocical or surgical procedures.

Treatment of subacute endocarditis usually involves high doses of antibiotics transmitted intravenously for a prolonged period of time. When damage to valvular tissue is extensive, surgery may be needed to replace or reconstruct affected valves.

Acute endocarditis is is frequently caused by the staphylococcus bacterium. It is similar to the subacute variety but it progresses very quickly. The valvular tissue rapidly degenerates and congestive heart failure ensues. The patient has a high fever and may present with localized collections of infection (abcesses) in other areas of the body, such as the kidneys or the brain. High doses of antibiotics are needed to treat this condition, but permanant valve damage is a frequent complication in patients who survive this devastating infection.

As frightening as endocarditis may be, it should be mentioned that this infection is rare even amongst those who fall into the high risk category. Bleeding gums after having brushed your teeth is not a sign that you may threatened by looming endocarditis, particularly if you have no conditions which predispose you to this disease. For endocarditis to be a significant risk factor, two independant conditions must be satisfied:

1- An area of the heart's endothelium (inner lining) must be damaged.

2- A bacteremia (bactria in the bloodstream) caused by adherent organisms must occur.

If damage to the endocardium is present but the bacteremia is lacking, endocarditis will not develop. Similarly, the presence

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