Endocarditis and Mitral Valve

[bbb]

Hi,
It's almost 1 year since my surgery and all is great with me. However, my best friend has had quite a week! He never knew he had anything abnormal with his heart. Last week, he had sudden fever, rigors, chills, etc. and I ended up taking him to the ER (where they almost discharged him) because his vital signs were all over the place. To make a long story short, they found he had endocarditis ( haemophilus parainfluenza) and with a TEE, that his mitral valve was abnormal (I think prolapsed?) and the chordee had ruptured. Apparently they think the mitral valve can be repaired. It had a vegetation on it seen in the echo, not seen in the TEE, that they thought has broken off and tiny pieces are in his brain and some extremities. But they seem to think the antibiotics will dissolve these. He is home on antibiotics for the next 4-6 weeks to clear the infection and then he will see a cardiologist to begin to plan for the surgery to repair his mitral valve.

Anyone else have any similar experiences? Do the antibiotics usually take care of the infection? What is the mitral valve repair surgery like?

Thanks, Betsy

 

[Dina]

The antibiotics should take care of it as long as the organism is not of a
resistant type and this is not very common.
Why do they believe a piece of the bacterial colony has broken off and
gone to his brain- is he experiencing neuro symptoms? IF a piece breaks off
from the MV this is where it goes(if Tricuspid it goes to lungs)but I would
think he would have symptoms from this.
My best-Dina

 

[Lisa in Katy]

Wow! What a shock that must be! I had endocarditis with RF. I was on plain old Pen VK and it did clear up the infection. Unfortunately, my valve was too bad to repair, so therefore I tick.

 

[bbb]

He had an MRI and they saw tiny embolic infarcts (I think thats the term) in 3 places in his brain. The docs did not seem too concerned though, and said they were so tiny they did not worry about them causing a stroke, altho this is still a possiblilty. He is home from the hospital today and has a very swollen thumb, which the docs said was from the embolism traveling to his extremities, but that it should clear up as he is on roceferin IV for the next 4-6 weeks.

 

[Dina]

He had an MRI and they saw tiny embolic infarcts (I think thats the term) in 3 places in his brain. The docs did not seem too concerned though, and said they were so tiny they did not worry about them causing a stroke, altho this is still a possiblilty. He is home from the hospital today and has a very swollen thumb, which the docs said was from the embolism traveling to his extremities, but that it should clear up as he is on roceferin IV for the next 4-6 weeks.

Okay that is good then that they are small, and I know that the meds will
break them down. Being asymptomatic is a good sign.
Make sure that after his drug therapy is completed and up to a month
later that he is aware of any recurring symptoms,this can return easily
and is what happened to me in 1992.
Dina

 

[MandyMV]

This happened to Ryan though unfortunately his went undiagnosed for so long he was rushed to surgery after only a week of antibiotics and had to have a valve replacement.

Some quick tips are to make sure he decides on a valve type for replacement prior to surgery for the repair. In Ryan's case the TEE showed only a fraction of what was really on his valve and did not show his abscess which had taken over his valve so no chance for a repair. They never really know until they are in there.

Be sure he gets follow-up MRIs for the infarcts and if they see a lot they might want to do an angiogram with contrast to check for aneurysms (not sure of name but it is like a cath but looks at the brain up close). Ryan had many small ones and one large one that caused a stroke and unfortunately knocked out his peripheral vision. However, even after several weeks of antibiotics one of the emboli had caused an aneurysm, luckily in an area of the brain we don't really use but it had to be "glued" none the less to avoid a bleed. The rest did clear up or didn't cause any problems. Also, while many of the emboli (he had a lot) when to his brain some also went to his hands, feet, kidneys, spleen and liver. The kidneys were compromised a bit with the addition of antibiotics so it helped the doctors to have contrast cat scans to know this to adjust his medications and avoid kidney failure.

All the best for their recovery and be happy to have caught it pretty early on...someday I am going to start a campaign for endocarditis awareness. I had never heard of it until Ryan almost died of it and it goes undiagnosed often especially in younger people.

Cheers,
Theresa

 

[Adrienne]

Although I knew I had a mitral valve prolapse and mitral regurgitation, the endocarditis took me totally by surprise because it must have been from a slightly bleeding gum - not a dental appointment! After 13 days of fever and horrible headaches (maybe little pieces got into my brain too, who knows), I went to the ER, was diagnosed with sub-acute bacterial endocarditis caused by the bacteria streptococcus virdans (sp?). I was in the hospital for 5 days on IV antibiotics (penicillin and gentimycin) and on an automatic pump at home for 4 more weeks. It totally cured the endocarditis, but it is probably the endocarditis that caused a lot of the calcium deposits on the valve.

I was able to have a complicated repair because of a very experienced surgeon. I also had two broken chordae. He replaced them with gortex neo-chordae.

 

[Dina]

Although I knew I had a mitral valve prolapse and mitral regurgitation, the endocarditis took me totally by surprise because it must have been from a slightly bleeding gum - not a dental appointment!

This is what always scares me--I rinse my mouth with peroxide almost
everyday in hopes of preventing something like that. Hindsight again!
I would have never thought to do this before "all this".
Dina

 

[Nupur]

So does everyone here take antibiotics before dental appointments to avoid endocarditis? I was told that AHA is no longer recommending it. I have a routine cleaning coming up and after reading the stories I feel like I should ask for them.

Nupur

 

[baradonai]

antibiotics

antibiotics

Hi, Yes I still take antibiotics before any dental work.

I had endocarditis and suspect a cleaning as the cause. Parts of my "vegetation" broke off and lodged in my brain causing a TIA stroke.

6 weeks of antibiotics flushed it all out.

 

[Adrienne]

I do especially since I have already had endocarditis.

 

[bbb]

I do, have a bovine valve and never had endocarditis and never want to! But I do know there is controversy over whether it helps or not. Great oral hygiene is the key, too!

 

[Marguerite53]

Hi Betsy. Glad to see that you've gotten some good information here. When he's up to it, invite your friend to join our forum.

Best wishes!

Marguerite

 

[Petros]

this is what always scares me--i rinse my mouth with peroxide almost
everyday in hopes of preventing something like that. Hindsight again!
I would have never thought to do this before "all this".
Dina

Same fears!

 

[bbb]

Why are antibiotics not recommended any more for dental procedures? Do they think they do not prevent endocarditis? Do they think you can not get endocarditis from dental procedures? What is the AHA's thinking here?

Thanks...