The diagnosis of endocarditis requires similar examinations as in the case of acute articular rheumatism, and the results are also very similar, except in the case of endocarditis they are much more severe.
A definitive diagnosis can be made via an objective examination which will involve investigating for auscultative symptoms, which are the only symptoms which can belie potential damage of the endocardium.
Usually the first sound at the apex is weakened, the second tone in the pulmonary artery remains clear or becomes enhanced. A weakening of the sounds is a consequence of the edematous infiltration of the valves, which is why they are audible at the onset of the condition, but when the valves later on become fibrous, the sounds become louder and more dry.
If under the effect of therapy the valve process heals, the sounds will become normal once again, but if the valves begin scarring over abnormal heart sounds will become audible. A phonography is usually involved in order to be able to hear heart sounds.
Rheumatic endocarditis is an inflammation of the endocardium. The inflammatory process if mostly localized in the valve endocardium, the layerÃƒâ€šÃ‚Â whichÃƒâ€šÃ‚Â covers the tendons and papillary muscles, and rarely the parietal endocardium may be affected.
Clinical symptomsÃƒâ€šÃ‚Â appear 8 to 10 days after the rheumatic attack and they include: high fever (rises and falls periodically), extreme fatigue, rhythm disruptions, a feeling of heaviness and pain in the precordium, dyspnea (difficulties breathing).
The main cause for this disease is theÃƒâ€šÃ‚Â betahaemolyticÃƒâ€šÃ‚Â StreptococcusÃƒâ€šÃ‚Â of group A, which is found in common infectious sites such as the mouth; in dental granulomas, dental abscesses,Ãƒâ€šÃ‚Â paradontosis, and other infections such as chronic tonsillitis.Ãƒâ€šÃ‚Â Ãƒâ€šÃ‚Â
A definitive diagnosis can be made via an objectiveÃƒâ€šÃ‚Â examination whichÃƒâ€šÃ‚Â will involve investigating for auscultative symptoms, which are the only symptoms which can belie potentialÃƒâ€šÃ‚Â damage of the endocardium.
Rheumatic endocarditis patients may suffer from the following complications:Ãƒâ€šÃ‚Â rhythmÃƒâ€šÃ‚Â disruptions (like arrhythmias), cardiacÃƒâ€šÃ‚Â insufficienc (which often constitutes the most common cause of death of these patients), infarctions and embolisms, etc.
Prophylactic treatment is usually conducted via the use of antibiotics, just as in cases of acute rheumatic polyarthritis. Each time these patients suffer fromÃƒâ€šÃ‚Â bacterialÃƒâ€šÃ‚Â infectionsÃƒâ€šÃ‚Â they must be immediately medicated with antibiotics.