Endocarditis avoidance

[RunMartin]

Does anyone know what is the best way to prevent Endocarditis. I know dental work can cause Endocarditis. I do a lot of running in the country where I can get lots of cuts and scratches. Are cuts and scratches a source of Endocarditis? When I had my yearly check up at the hospital in February I asked the specialist nurse this question and she was not sure. Also can you get Endocarditis from open water swimming.

Thanks

Martin

 

[Eva]

Martin,

In case you could not open this website: http://www.mayoclinic.com/health/endocarditis/DS00409/DSECTION=causes here is a part about causes of endocarditis from Mayo Clinic :


"Endocarditis occurs when germs enter your bloodstream, travel to your heart, and attach to abnormal heart valves or damaged heart tissue. Bacteria cause most cases, but fungi or other microorganisms also may be responsible.

Sometimes the culprit is one of many common bacteria that live in your mouth, throat or other parts of your body. The offending organism may enter your bloodstream through:

Everyday oral activities. Activities such as brushing your teeth or chewing food can allow bacteria to enter your bloodstream — especially if your teeth and gums are in poor condition.
An infection or other medical condition. Bacteria may spread from an infected area, such as a skin sore. Gum disease, a sexually transmitted disease or an intestinal disorder — such as inflammatory bowel disease — also may give bacteria the opportunity to enter your bloodstream.
Catheters or needles. Bacteria can enter your body through a catheter — a thin tube that doctors sometimes use to inject or remove fluid from the body. The bacteria that can cause endocarditis can also enter your bloodstream through the needles used for tattooing or body piercing. Contaminated needles and syringes are a concern for people who use intravenous (IV) drugs.
Certain dental procedures. Some dental procedures that can cut your gums may allow bacteria to enter your bloodstream.
Typically, your immune system destroys bacteria that make it into your bloodstream. Even if bacteria reach your heart, they may pass through without causing an infection.

Most people who develop endocarditis have a diseased or damaged heart valve — an ideal spot for bacteria to settle. This damaged tissue in the endocardium provides bacteria with the roughened surface they need to attach and multiply."

 

[Tell-Tale Heart]

I can't answer your question about scratches, but it's important to avoid infection of any kind anywhere.
My dentist told me to rinse with Listerine BEFORE you floss and brush, as well as after. Listerine does kill a lot of bacteria and he said doing this (in addition to pre-medication before appointments) is another tool to keep infection away.
I also always have peroxide and neosporin on hand for anything from small cuts to torn cuticles. Don't know if it's paranoid, but I know it doesn't hurt.

 

[tommy]

I believe that my endocarditis was assisted by stress and being overly tired from a new job and relocating my family. I think that my immune system was compromised. I've also read that immume systems can be compromised by long runs, particulary long races where you give it your "all". So, get your rest, and take your antibiotics for dental work.

 

[ElectLive]

The American Heart Association put out a "prevention" publication a few years ago with a very thorough analysis as part of the updated medical guidelines: http://circ.ahajournals.org/content/116/15/1736.full.pdf

I really hate saying this, but truth be told, it's completely impossible to avoid risk entirely - so many everyday activities (such as eating food) involve a potential, although thankfully slight, risk for valve patients. As that publication points out, everyday risk is likely even more impactful than those 2 visits to the dentist per year we all worry about. My own prevention "paranoia" comes and goes, much more so now, though, than before my replacement. I do my best to exercise reasonable caution (such as consistently good dental habits) and try not to worry about the unavoidable. Theoretically, I could get endocarditis just by being diabetic, due to my forever use of an insulin pump, glucose sensors, and blood testing. But it's another very small risk, and should that ever happen, well that's life. You educate yourself, control what you can, then just hope for the best for the rest.

 

[carolinemc]

I agree with Electlive, it is impossible to avoid every germ known to common man. And it is not so great to worry about it so much. Even the healthiest person can contract encarditis. So just live life to the fullest you possibly can. Don't sweat what you cannot control. Just do the best you can to take great care of the body you have. Hugs for today.

 

[MrZoom]

My surgeon is concerned about me contracting endocarditis from a urinary infection. I have a history of UTIs, because I self-catheterize, which is why a homograft valve was selected for my valve replacement last year - lowest risk of the valve itself becoming infected.

I started using "closed system" catheters last year, after the surgery. Those kits provide about the most sterile procedure you can use, but even then I had a bad run of UTIs last summer. Eventually my urologist put me on suppressive antibiotic therapy. I will go off that therapy at the end of this month.

I have a theory, haven't discussed it with my doctors, but .... each UTI I had last summer came back with the same bacteria, e.coli. I was also taking Lasix at the time and was not always getting to the bathroom before I got over-full. I think getting over-full as I did may have prevented me from getting all the e.coli out of my system. So on one occasion I ended up in the ER with a "new" infection 2 or 3 days after finishing a course of Bactrim.

When I mentioned to my surgeon that I was taking Lasix last Thursday, at my one year follow up appointment, he said he does not think I need to take it anymore. So I stopped. So far, no adverse effects except that I am still adjusting to a more "normal" schedule of using the facilities. I am hopeful that once I am adjusted to this schedule, being strict with myself about keeping to said schedule will help me avoid any more UTIs.

 

[pgammo]

This scares me, as I have horrible teeth and a long history of cavities and root canals.

 

[Duffey]

Martin,
I do alot of swimming. At one time, I did alot of open water swimming. I shy away from it now. There's too much chance of getting bacteria or viruses in my eyes, nose, ears, mouth to suit me. I swim at a pool facility that I know is always spot-on for the chlorination level.

 

[sarahsunshine]

We had a discussion of endocarditis with Skyler's cardiologist. His view (that I agree with quite completely) is that you take all the regular health precautions on a regular basis (brush teeth, wash hands, shower reasonably frequently, exercise reasonably, and don't get infections if you can help it). Other than that, the chances of getting endocarditis are so small and so spread out that the chances of getting it are minute in comparison to the stress of living in fear of getting it.

Go live a happy and healthy life, and relax. Do your best, but don't live in a vaccuum!

 

[Bryan B]

I had bacterial endocarditis in 2003 and I have to admit that it's always in the back of my mind, especially if I am not feeling well for any reason (because the symptoms of BE are the same as so many symptoms of unrelated illnesses). I try to do the things Sarah mentioned to reduce my chances, but beyond that all I can really do is to beware of the telltale symptoms and not hesitate to go to the doctor if I suspect something is awry. I believe my endocarditis started manifesting itself in July but it was not diagnosed for nearly 4 months. If it were caught earlier my valve probably would have been able to be saved.

 

[normofthenorth]

We've discussed pre-rinsing (before brushing, flossing, toothpicking, etc.) with a "germ-nasty" mouthwash like Listerine, and many of us thought it sounded like a great idea. I've been doing it for many years, starting before I even knew I had a BAV. I only swim in lake water when I tip a sailboat over -- more often than "never", but less than "often" -- and I otherwise don't think about it.
I've only heard radio news reports about the brand-new study (meta-study?) showing a LACK of correlation (or at least a lack of sign of causation) between periodontal disease and heart problems, but it may well be relevant to this discussion.

 

[piglet]

I had endocarditis requiring valve replacement last April. Due to rheumatoid arthritis I take immunosuppressants daily. I try not to worry too much about reinfection and follow all of the precautions already listed. The RA makes me a bit clumsy due to stiff joints and I frequently injure myself so I keep anti-bacterial Band-aids on hand. As for the swimming I would just be careful of murky or stagnent water.
I've been given a second chance to live and I refuse to squander it. My advice is to prepare for the worst and experience the best.