什么是心内膜炎?
心内膜炎 is an infection of the heart valves and inner lining of the heart. (The inner lining of the heart is called the endocardium.) It is a rare but serious and sometimes fatal illness. 心内膜炎 can cause growths on the heart valves or inside the heart called vegetations.
Over time, these growths can destroy the heart tissue and valves. 它们会导致 心脏衰竭 或者是心律失常. 植被也会引起 中风 if they break away and block an artery in the brain.
感染性心内膜炎
Infective endocarditis starts when a bacteria or another type of germ, 像真菌, 进入血液. Your immune system usually destroys harmful germs that enter the bloodstream. 然而, as some bacteria circulate in your blood and cycle through the heart, 它们可引起感染性心内膜炎.
感染性心内膜炎有两种形式：
- 急性心内膜炎 – This form of endocarditis develops suddenly and may become life threatening within days.
- 亚急性或慢性 – This form develops slowly over a period of weeks to several months.
心内膜炎的症状
Symptoms of endocarditis include the following:
- 发烧（102˚- 104˚）
- 发冷
- 心跳加快或呼吸困难
- 盗汗
- 疲劳
- 关节和肌肉疼痛或虚弱
- 肿胀：脚、腿或腹部肿胀
- 减肥
- 手掌上有无痛的红点
- Tiny red spots on the skin, under the fingernails, in the whites of your eyes, and inside your mouth
- 尿中带血
心内膜炎的原因?
Bacteria normally live on and in your body, such as on your skin, in your mouth, or in your gut. 然而, bacteria can sometimes make its way into your bloodstream. 这些被称为菌血症. The bacteria may travel to your heart and settle in the lining of the heart or valves.
There are multiple ways bacteria can enter your bloodstream. 一些例子包括：
- 在医学或牙科检查或程序之后.
- An infection or other medical condition, such as gum disease or inflammatory bowel disease.
- Having a catheter in your body for long period of time.
- Through needles used for tattooing, body piercing, or intravenous drug use.
找专家
谁有患心内膜炎的风险?
心内膜炎 is more likely to develop in people who have:
- 心脏缺陷；
- 瓣膜疾病, like mitral prolapse or valve damage from an infection such as rheumatic heart disease;
- 人工心脏瓣膜；
- 静脉吸毒；
- 牙齿或口腔感染问题；
- 血液透析治疗肾衰竭；
- catheter in a vein or blood vessel for a medical procedure; or a
- 免疫系统弱.
心内膜炎如何诊断?
There are multiple ways a physician can diagnose endocarditis. These include a physical exam and different tests or procedures.
物理考试
A health care provider will listen to your heart to check for abnormal heart sounds or murmurs. They will also examine your body for the signs and symptoms, 比如皮肤或指甲上的红斑.
测试和程序
- 超声心动图 – an ultrasound to see your heart valves and heart structure to look for abnormalities. It can be done by either using a probe that is pressed against your chest wall or by inserting the probe through the mouth and esophagus.
- 心电图(心电图) -检查你的心律
- 心脏CT – a series of X-ray images that looks at the heart and other body parts to check if the infection has spread to different areas.
- 血液测试 – these can include blood cultures to identify what type of germs are causing endocarditis, 血细胞计数, 肝肾功能, 炎症标记物, 如CRP和ESR.
What Treatment Options Are Available for 心内膜炎?
Your treatment will depend on what causes your endocarditis. 然而，有多种选择. 其中包括：
住院
You may be in the hospital for a week or more and receive medications in your veins and other areas.
药物
You may be given antibiotics to treat bacterial infections. This is given through an IV to be more effective against the infection. You may need to be on more than one antibiotic medicine. 治疗可能持续两到六周. How long you take the antibiotics will depend on how your body responds to the treatment.
We may also use antifungal medication to treat fungal infections. Sometimes your health care provider may recommend lifelong treatment to prevent the infection from returning.
You may also be placed on blood thinners to prevent blood clots from occurring and causing further damage
手术
You may require surgery to remove the infected tissue. We may need to replace a damaged heart valve with a prosthetic valve.
你能预防心内膜炎吗?
There are multiple ways to prevent endocarditis:
- 避免非法静脉注射毒品.
- 注意皮肤卫生, such as regularly washing your skin and immediately washing any cuts or scrapes to prevent infection.
- 保持良好的口腔卫生, including daily brushing and flossing and regular visits to the dentist.
- Take all antibiotics you are prescribed for strep throat or other infections.
You may need to take antibiotics before some medical procedures to prevent endocarditis if you have:
- 人工心脏瓣膜，
- 先天性心脏缺陷
- history of infectious endocarditis in the past.
大发娱乐犹他大学健康中心的团队
University of Utah Health has a full-service team that’s here for you from diagnosis to treatment. Our endocarditis health care experts include representatives from internal medicine, 传染性疾病, 心血管药物, 心胸外科手术, 行为健康和成瘾药物, 护理与护理管理.
下一个步骤
If you would like to be evaluated by one of our specialists, you can make an appointment. 大发娱乐的服务不需要推荐. 然而, check with your insurance to see what they require.
倾听病人的心声
科比·巴克对心脏手术并不陌生. 时年56岁, he’d already undergone two open-heart operations to replace his aortic valves, 源于慢性心脏疾病. But Kirby came to University of Utah Health for something he couldn’t find anywhere else. a diverse team of skilled specialists collaborate to provide an unprecedented standard of truly personalized care.
给柯比和他的妻子, 露丝, these specialists became known as the Kirby Barker 心 Dream Team, performing back-to-back heart valve replacement procedures with remarkable results.