In recent years, the prevalence of infective endocarditis (IE) has continued to rise, and it has changed from a rare disease to a more common cardiovascular disease. However, due to its complex and changeable symptoms and rapid progress, its diagnosis, treatment and Nursing is still very challenging.
Pathogenic microorganisms run into the body and endanger the heart
Infective endocarditis refers to an inflammatory disease caused by bacteria, fungi and other microorganisms directly invading the endocardium, and the formation of neoplasms on the surface of the heart valve or ventricular wall. In the general population, 3 to 10 patients per 100,000 people are affected by IE, and its hospital mortality rate is as high as 15% to 30%. It can be said to be the "devil in the heart", which is unpredictable and extremely harmful.
According to the course of the disease, IE can be divided into acute and subacute IE. The pathogens of acute IE are mainly Staphylococcus aureus and Streptococcus pyogenes; the pathogens of subacute IE are mainly Streptococcus viridans, as well as Streptococcus bovis, Staphylococcus epidermidis, and Enterococcus. Fungal endocarditis is often caused by Candida albicans.
The symptoms are complex, but there are still signs to follow
Unlike infections of other organs, the strongest "killer" of endocarditis is the neoplasms that it forms on the heart valve, because the heart valve is equivalent to the first pass of the heart's internal passage, and the pathogenic bacteria are first on the valve. Continue to multiply, leading to insufficiency or obstruction of heart valves, myocardial abscess and abnormal cardiac conduction function. After breaking through this barrier, extremely unstable neoplasms can fall off at any time and reach various parts of the body with blood circulation, and severely embolize the heart. , Brain, lungs, kidneys and other important organs, even leading to sudden death.
General infective endocarditis has the following 4 characteristics: First, limb weakness, unexplained fever, and muscle soreness will appear. These symptoms are similar to the fever caused by the common cold. Many patients will take some cold and fever reducing drugs, but If you stop taking the anti-fever medicine, the symptoms of chills and fever will be repeated. Secondly, patients with infective endocarditis may have anemia, heart murmurs and even heart failure. These should be differentiated from myocarditis caused by colds. Finally, infective endocarditis can also cause petechiae on the skin and mucous membranes. It can also be found in the hands and feet. In severe cases, it may also cause spleen enlargement, pulmonary embolism, cerebral artery embolism, skin ecchymosis, etc. After the endocardium is infected by the virus, vegetations will be produced. These vegetations will gradually increase and fall off and flow along the blood to various parts of the body. Once blocked, it will cause embolism and petechia. Among these features, such as skin petechia and fever, it is easy to mislead the patient to diagnose other diseases. If you have such symptoms in your life, you must be vigilant, go to the hospital for cardiac ultrasound examination in time, and achieve early detection and early treatment.
Early treatment + correct care, increase the cure rate
Such a difficult clinically critical illness should be actively treated once it is diagnosed or highly suspected. At present, the clinic has a very clear plan for its treatment: antibiotics, or antibiotics + surgery. Timely treatment can reduce the mortality rate and greatly increase the cure rate. At the same time of treatment, medical staff and family members should also give patients the correct care, which is of great help to improve the treatment effect. Specifically including-
condition observation, measuring body temperature every 4-6 hours, and accurately drawing body temperature curve; observing whether there is skin petechia, finger (toe) linear hemorrhage, etc. and its regression; observing pupil, mind, and limb activity And skin temperature, etc. When the patient suddenly has symptoms such as chest pain, shortness of breath, cyanosis and hemoptysis, the possibility of pulmonary embolism should be considered; the possibility of renal embolism should be considered when the patient has low back pain, hematuria, etc.; mental and mental changes, aphasia, dysphagia, limb dysfunction, pupil size When there are signs of asymmetry, or even convulsions or coma, be alert to the possibility of cerebrovascular embolism; sudden severe pain in the limbs, drop in local skin temperature, weakened or disappeared arterial pulsation should consider the possibility of peripheral arterial embolism.
Rest. Patients with high fever should stay in bed and give physical cooling at the same time. Patients with huge growths visible on echocardiography should absolutely rest in bed to prevent the growths from falling off.
The diet provides light, high-protein, high-calorie, high-vitamin, and digestible semi-liquid or soft food. Encourage patients to drink more water and take good oral care.
The medication should be treated with antibiotics in accordance with the doctor's order, the efficacy of the medication and possible adverse reactions should be observed, and the doctor should be reported in time. The medication should be administered strictly according to time to ensure that the effective blood concentration is maintained.
