Thursday 20th August 2020
Consultant cardiologist Bernard Prendergast and patient David Eaton come together to chat about endocarditis
David Eaton: “Hi, Bernard, thanks for taking the time to talk with me today. Wil Woan, CEO of Heart Valve Voice, and I were discussing my story the other day – about endocarditis and the dangers of it. Can you tell me a little bit about what endocarditis is?”
Bernard Prendergast: “Hi, David, a pleasure to talk to you. Endocarditis, at its most basic form, is an infection of the inner lining of your heart chambers and heart valves. Normally, this occurs when bacteria, fungi or germs from another part of your body speed through your bloodstream and damage your heart.”
DE: “So, why is it so dangerous?”
BP: “Well, if it isn’t treated quickly it is life-threatening. The infection can destroy your heart valves, which affects the journey of the blood passage in the heart and can lead to heart attack, stroke and organ failure.”
DE: “So how can patients and clinicians identify endocarditis?”
BP: “Early detection is critical. Patients need to be aware of the signs and symptoms – fever and chills, fatigue, aching joints and muscles, night sweats, shortness of breath and chest pain – and respond immediately to changes in their health. And then you need a good investigative heart team who can spot the signs early.”
DE: “I remember my intense backache and fatigue vividly. I thought I was maybe burning the candle at both ends, and it was my friend who realised the severity of my condition. What makes a good investigative heart team?”
BP: “Well, like yourself, it is easy to associate many of the symptoms with other conditions, or even just being run down. But a good investigative heart team asks the right questions and then comes to the right conclusions. The clues for endocarditis are often in the history of the patients, so it can be a bit of a detective story. Endocarditis isn’t always at the front of a healthcare professional’s mind, but often, once discovered, all the classic signs and symptoms were there.”
DE: “I see what you mean. Someone needs to recognise the signs as soon as possible.”
BP: “Exactly, because time is of the essence with endocarditis. Things can happen very quickly, and what you can’t have is patients bouncing between clinicians looking for solutions.”
DE: “Is there anything that patients should be aware of regarding endocarditis?”
BP: “Oral hygiene is an important one. Often infective endocarditis patients have had some dental issue in the recent past, which carries a big risk of infection. These bacterial infections then develop into endocarditis, and things can snowball from there. My advice to valve patients is to practice good oral hygiene and talk to their dentist about their condition so that they are fully aware. That way each patient has another healthcare professional watching for the signs and symptoms of endocarditis.”
DE: “That’s good advice and something I’ve said to many people myself. You mention the impact on patients waiting for valve disease treatment, but what about for those who have already been treated? What can happen to their valve?”
BP: “ Well endocarditis is more prevalent for those with a new murmur, as it is in a change in the nature of an existing murmur. However, it is still a danger for those treated for valve disease. Even once treated, there is still a risk of infection around the treated valve or, as with some valves, they have a shorter life span so your valve team still need to have that investigative edge post-treatment during your check-ups.”
DE: “Thank you, Bernard, and thank you for taking the time to talk to me today.
BP: “You’re very welcome, David. Thanks for your excellent questions.”