Endocarditis

Endocarditis is an inflammation of the endocardium a membrane that covers connective tissue in heart valves and lines heart chambers. Most cases are caused by a bacterial infection. Endocarditis is a serious ailment that can lead to severe medical complications and can even be fatal if not treated.

Signs and Symptoms

The most common symptom of endocarditis is fever. The fever may be high or low and it may seem to come and go. Other common symptoms include the following.

• Skin sores
• Night sweats
• Chills
• Discomfort or uneasiness
• Muscle joint back pain
• Muscle weakness
• Stiff neck
• Headache
• Seizures
• Stroke
• Heart attack
• Difficulty speaking
• Paralysis
• Numbness
• Cold painful hands and feet
• Small purplish spots on skin
• Bloody urine
• Bloody phlegm
• Painful tips of fingers or toes
• Shortness of breath
• Cough
• Unnatural pallor

What Causes It?

Most of the causes of endocarditis are related to a bacterial infection. Heart conditions that increase your risk include having mechanical heart valves a previous case of endocarditis heart defects and dysfunctions and degenerative heart disease. Dental and surgical procedures that increase your risk of infective endocarditis include dental procedures that irritate the gums tonsillectomy adenoidectomy intestinal and respiratory surgery gallbladder surgery cystoscopy bronchoscopy and vaginal delivery with an infection present.

What to Expect at Your Provider's Office

Your health care provider will listen to your heart and lungs take your pulse and check your eyes and skin. Your provider likely will order a number of tests which could include blood tests urine analysis an echocardiogram a computed tomography scan and a cinefluoroscopy (a motion-picture type heart scan). In most cases your provider will admit you to the hospital possibly in intensive care until your condition is better understood and your symptoms are under control.

Treatment Options

Treatment Plan

Treatment usually involves a combination of antibiotics given intravenously. The treatment typically takes 2 to 6 weeks. You will probably be in the hospital for all or most of this time. The kind of antibiotics you are given depends on the type(s) of bacteria causing your disease. In severe cases surgery also may be necessary.

Drug Therapies

Prescription

• Antibiotics—numerous types selected by the type and cause of your endocarditis; two to three types are usually used together; various possible side effects

Over the Counter

N/A

Complementary and Alternative Therapies

Endocarditis has serious ramifications and requires aggressive medical treatment. Alternative therapies may be used concurrently to help reduce severity duration and progression of disease.

Nutrition

• To support immune function include vitamins C (1 000 mg up to three times a day) E (400 to 800 IU a day) A (10 000 IU/day) or beta carotene (100 000 IU a day) selenium (200 mcg a day) and zinc (30 mg a day).
• Coenzyme Q10 (100 mg twice a day) protects the heart.
• Magnesium (200 to 500 mg two to three times a day) for normal cardiac function. Do not take if you have kidney damage.
• Bromelain (250 to 500 mg three times a day between meals) is a proteolytic enzyme that may increase the effectiveness of antibiotic therapy.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers; 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

• For long-term cardiac support combine the following herbs in a tea (3 cups per day) or tincture (30 to 60 drops three times a day): 2 parts hawthorn (Crataegus oxyacantha) with 1 part each motherwort (Leonorus cardiaca) and linden flowers (Tilia cordata). Use additional herbs from the following categories as needed.
• Cardiac arrhythmias: Add 1 part each lily of the valley (Convalleria majus) and night-blooming cereus (Cactus grandiflorus) to the cardiac formula above. These herbs must be used with caution and under a health care provider's supervision.
• Hawthorne berry can be helpful in decreasing arrhythmias. Use 1/2 tsp. of the solid extract or 1 000 mg three times per day.
• Infection: Combine equal parts of four to six of the following herbs: coneflower (Echinacea purpura) goldenseal root (Hydrastis canadensis) wild indigo (Baptisia tinctoria) myrrh (Commiphora molmol) garlic (Allium sativum) rosemary (Rosemariana officinalis). For acute infection take 60 drops of tincture every two hours. For chronic infections or for prophylaxis take 30 to 60 drops three times per day.
• Renal involvement: Combine equal parts of bearberry (Arctostaphylos uva ursi) cleavers (Galium aparine) dandelion leaf (Taraxecum officinalis) black cohosh (Cimicifuga racemosa) yarrow (Achillea millefolium) and corn silk (Zea mays). Drink 3 cups per day.

Homeopathy

Some of the most common remedies for this condition are listed below.

• Aconite if you fear death have rapid heartbeat (tachycardia) with full hard bounding pulse of sudden onset
• Cactus grandiflorus for endocarditis with mitral insufficiency. You may have a feeble irregular pulse and feel a chest constriction.
• Digitalis if you have an irregular pulse with a sensation as if your heart would stop if you moved
• Spongia if you have a sensation of the heart swelling

Acupuncture

Acupuncture may help improve immunity and strengthen cardiac function.

Following Up

In addition to monitoring your condition while you are in the hospital your health care provider will order follow-up procedures such as blood tests to determine how well the prescribed treatment is working.

Supporting Research

Barker LR Burton JR Zieve PD eds. Principles of Ambulatory Medicine. 4th ed. Baltimore Md: Williams & Wilkins; 1995:379–381.

Bartram T. Encyclopedia of Herbal Medicine. Dorset England: Grace Publishers; 1995:99 167–168 220.

Dambro MR. Griffith's 5-Minute Clinical Consult–1999. Baltimore Md: Lippincott Williams & Wilkins; 1999:358–361.

Endocarditis: a rare but serious disease. Drug Ther Perspect. 1998;12(4):6–9.

Gruenwald J Brendler T Jaenicke C et al eds. PDR for Herbal Medicines. Montvale NJ: Medical Economics Company; 1998:772–773 1130–1131.

Kruzel T. The Homeopathic Emergency Guide. Berkeley Calif: North Atlantic Books; 1992:58–61.

Murray MT. Encyclopedia of Nutritional Supplements. Rocklin Calif: Prima Publishing; 1996:401 404 463–464.

Snow JM. Hydrastis canadensis L. (Ranunculaceae). The Protocol Journal of Botanical Medicine. 1997;2:25–28.

Stein JK ed. Internal Medicine. 4th ed. St. Louis Mo: Mosby-Year Book; 1994:189–201.

Stoller JK Ahmad M Longworth DL eds. The Cleveland Clinic Intensive Review of Internal Medicine. Baltimore Md: Williams & Wilkins; 1998:137–141 299.

Walker LP Brown EH. The Alternative Pharmacy. Paramus NJ: Prentice Hall Press; 1998:239–240.

Werback MR. Nutritional Influences on Illness. New Canaan Conn: Keats Publishing Inc; 1987:252–262.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.