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Subacute bacterial endocarditis (SBE) is an infection that affects the inner lining of your heart (endocardium) and valves. It progresses slowly, unlike its more aggressive counterpart, acute bacterial endocarditis. This condition is less common but equally serious, requiring prompt diagnosis and treatment. The prevalence of SBE has been challenging to pinpoint accurately due to its insidious onset and the broad spectrum of symptoms it presents. However, it's crucial to understand that anyone with heart valve problems, previous heart valve surgery, or congenital heart defects is at an increased risk.
SBE is most commonly caused by bacteria entering the bloodstream and attaching to damaged areas of the heart’s endocardium. This can happen through everyday oral activities like brushing teeth, especially if the gums are in poor condition, dental procedures, or other invasive procedures that allow bacteria to enter the bloodstream. People with existing heart conditions or those who have had heart surgery are more susceptible because they already have areas within their heart that are less capable of resisting bacterial infection.
- Fever, usually low-grade - Fatigue and weakness - Night sweats - Joint and muscle aches - Chest pain when you breathe - Shortness of breath - Swelling in your feet, legs, or abdomen - Paleness or prolonged capillary refill time - Small, painless nodules on your fingers or toes - Tiny red spots on your skin called petechiae, usually on the roof of your mouth, under the nails, on the chest, or on the whites of the eyes
Diagnosing SBE involves reviewing your medical history, performing a physical examination, and running specific tests. Blood cultures are crucial for detecting bacteria in the bloodstream. Echocardiograms, both transthoracic and transesophageal, help visualize the heart's structures and confirm the presence of vegetations (bacterial clumps) on the heart valves. Complete blood counts and inflammatory markers like C-reactive protein (CRP) levels may also support the diagnosis by indicating an ongoing infection within the body.
Preventing SBE, especially in those with known risk factors, involves maintaining good oral hygiene and receiving antibiotic prophylaxis before dental and other procedures that may introduce bacteria into the bloodstream. For those who seek functional medicine perspectives, bolstering the body’s natural defenses through a heart-healthy diet rich in anti-inflammatory foods, regular physical exercise, stress management techniques, and ensuring adequate sleep is beneficial. Treatment for SBE typically requires a prolonged course of antibiotics to eradicate the infecting organism. In functional medicine, supporting the body during this time is crucial. Nutritional supplementation to boost the immune system, such as high doses of vitamin C, zinc, and probiotics to address potential antibiotic-related gut flora imbalances, may be recommended. Natural therapies, including herbal remedies like garlic, known for its antimicrobial properties, could complement conventional treatment under supervision. However, it's imperative to consult with healthcare providers to create a personalized, integrated treatment plan that includes both conventional and natural therapies to address SBE effectively.