Dear Sam,

Rheumatic fever can damage body tissues by causing them to swell, but its greatest danger lies in the damage it can do to your heart. More than fifty percent of the time, rheumatic fever causes scarring of the heart's valves. This scarring puts you at a higher risk of developing bacterial endocarditis. Bacterial endocarditis is an infection of the hearts inner lining or the heart’s valves. The inflammation can occur anywhere in the heart, but usually affects previously damaged heart valves. A normal heart has a smooth lining and valve surfaces making it difficult for bacteria to stick to it. If the heart is abnormal due to certain types of surgery or other defects, there may be rough surfaces that allow the bacteria to take hold. Once the bacteria infect the inner surface of the heart, they continue to grow producing large colonies called vegetation that may then break off and travel to the lungs, brain, kidneys and skin. The continuing infection may also seriously damage the heart valve on which the vegetations have grown.Bacterial endocarditis is a life-threatening infectious disease.  

 

The symptoms of bacterial endocarditis depend on whether the infection is acute or sub-acute. Symptoms may include:

·         Fever, chills, sweating, and night sweats.

·         Chest pain

·         Coughing and shortness of breath. You may even cough up blood.

·         Headaches, back pain, muscle and joint pain.

·         Blood in the urine.

·         Nausea and vomiting.

·         Blood in the whites of your eyes. Also red spots on your fingers, toes and under your fingernails.

·         Irregular heartbeats.

                   

The good news is the risk of bacterial endocarditis can be greatly reduced by:

Keeping your mouth healthy and disease free. Taking antibiotics prophylactically before any dental procedure that introduces bacteria into your bloodstream. The antibiotic of choice is Amoxicillin. The recommended dose is 2 grams one hour prior to the dental procedure. For patients who are allergic to amoxicillin, alternative antibiotics are clindamycin, azithromycin and keflex. It is also a good idea to carry a bacterial endocarditis wallet card. You can obtain one from the American Heart Association.

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Better smiles for all.

 

John J. Russo DDS