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Treatment of Endocarditis

Due to the difficulties associated with the organization of treatment in Turkey, Switzerland, South Korea and India, we are not currently processing requests to these regions.

If you are interested in treatment in Germany, please leave a request and our specialists will contact you as soon as possible.

 

Cost for treatment

Endocarditis diagnosis
 from  542
Conservative treatment of endocarditis
 from  2173
Pericardial drainage to treat endocarditis
 from  6357

St. Vincentius Hospital Karlsruhe-Academic Hospital of the University of Freiburg

9.8/10
location_onGermany, Karlsruhe

Department of Cardiology, Angiology and Intensive Care Medicine

The St. Vincentius Clinic is the largest multidisciplinary medical institution and academiс hospital of the Albert Ludwig University of Freiburg. Treatment and diagnosis of patients is conducted by doctors with a scientific degree. They are introducing the latest progressive techniques. The clinic has at its disposal the latest
Endocarditis diagnosis
2003 help1823
Conservative treatment of endocarditis
6728 help5928
Pericardial drainage to treat endocarditis
18543 help16543

University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Cardiology, Angiology and Internal Intensive Care

The University Hospital Ulm started its activities 35 years ago and during this time it has become one of the most prestigious medical institutions in Europe. The hospital is famous for its numerous discoveries and the world-class achievements in medicine and pharmaceuticals. The medical facility has 29 specialized departments a
Endocarditis diagnosis
2096
Conservative treatment of endocarditis
5769
Pericardial drainage to treat endocarditis
18530

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Department of Cardiology and Angiology

According to the authoritative Focus magazine, the Charite University Hospital Berlin occupies the first place in the rating of the top German medical facilities! The hospital is one of the largest and leading university medical complexes in Europe. The hospital in Germany provides modern diagnostics and treatment of patients, a
Endocarditis diagnosis
2729
Conservative treatment of endocarditis
9126
Pericardial drainage to treat endocarditis
26068

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Cardiology, Angiology and Pulmonology

According to the Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany! The hospital is one of the most advanced and reputable medical institutions not only in Germany, but throughout Europe. There are more than 43 specialized departments and 13 medical institutes, which cover all field
Endocarditis diagnosis
0
Conservative treatment of endocarditis
0
Pericardial drainage to treat endocarditis
0

University Hospital RWTH Aachen

8.7/10
location_onGermany, Aachen

Department of Cardiology, Pulmonology and Angiology

According to the prestigious Focus magazine, the University Hospital RWTH Aachen ranks among the top German hospitals! As a maximum care university medical facility, the hospital guarantees patients first-class medical services combined with a respectful and human attitude. The hospital integrates all the modern options for the
Endocarditis diagnosis
2117
Conservative treatment of endocarditis
6969
Pericardial drainage to treat endocarditis
19486

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of Cardiology and Angiology

According to the reputable Focus magazine, the University Hospital Frankfurt am Main ranks among the top German medical facilities! The hospital was founded in 1914 and today is a well-known German medical facility, which combines rich traditions and scientific innovations. A medical team of more than 6,500 employees cares about
Endocarditis diagnosis
1936
Conservative treatment of endocarditis
6333
Pericardial drainage to treat endocarditis
17856

University Hospital Jena

8.9/10
location_onGermany, Jena

Department of Cardiology, Angiology, Pulmonology and Intensive Care

According to the prestigious Focus magazine, the University Hospital Jena regularly ranks among the top German medical facilities! The hospital has positioned itself as a multidisciplinary medical facility with a long history of more than 200 years. Since its foundation, the hospital has been constantly developing and modernizin
Endocarditis diagnosis
2084
Conservative treatment of endocarditis
7036
Pericardial drainage to treat endocarditis
19895

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

Department of Cardiology and Angiology

According to the Focus magazine, University Hospital Erlangen ranks among the best medical facilities in Germany! The hospital is one of the leading healthcare facilities in Bavaria and offers top-class medical care distinguished by the close intertwining of clinical activities with research and training of medical students. The
Endocarditis diagnosis
2015
Conservative treatment of endocarditis
5955
Pericardial drainage to treat endocarditis
18469

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Cardiology, Endocrinology, Nephrology and Pulmonology

According to the Focus magazine in 2019, the University Hospital Würzburg ranks among the top national German hospitals! The hospital is one of the oldest medical facilities in Germany. The centuries-old traditions of first-class treatment are combined with the very latest achievements of modern evidence-based medicine and
Endocarditis diagnosis
2016
Conservative treatment of endocarditis
6309
Pericardial drainage to treat endocarditis
17408

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

Department of Cardiology

According to the Focus magazine, the University Hospital of Ludwig Maximilian University of Munich is regularly ranked among the best medical institutions in Germany! The hospital is the largest multidisciplinary medical facility, as well as a leading research and training center in Germany and Europe. The hospital is proud of i
Endocarditis diagnosis
2154
Conservative treatment of endocarditis
6174
Pericardial drainage to treat endocarditis
20023

University Hospital Duesseldorf

9.5/10
location_onGermany, Duesseldorf

Department of Cardiology, Pulmonology and Angiology

According to the authoritative Focus magazine, the University Hospital Duesseldorf ranks among the top Germany hospitals! The hospital is an excellent example of a combination of high-quality health care, research and teaching activities. With more than 50,000 inpatients and about 300,000 outpatients every year, the hospital is
Endocarditis diagnosis
2208
Conservative treatment of endocarditis
6980
Pericardial drainage to treat endocarditis
19694

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Cardiology, Angiology and Internal Intensive Care

According to the prestigious Focus magazine, the University Hospital Halle (Saale) ranks among the top German medical facilities! The history of the hospital has more than 300 years, and during this time it managed to earn an excellent reputation not only in Germany, but throughout the world. The hospital positions itself as a s
Endocarditis diagnosis
2000
Conservative treatment of endocarditis
6361
Pericardial drainage to treat endocarditis
17377

University Hospital Marburg UKGM

8.6/10
location_onGermany, Marburg

Department of Cardiology, Angiology and Internal Intensive Care

The University Hospital Marburg UKGM offers patients modern diagnostics and comprehensive therapy at the international level. As a maximum care hospital, the medical facility specializes in all fields of modern medicine ranging from ophthalmology to traumatology and dentistry. The main areas of specialization of the hospital are
Endocarditis diagnosis
1842
Conservative treatment of endocarditis
5872
Pericardial drainage to treat endocarditis
16638

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Cardiology, Angiology and Pulmonology

According to the prestigious FOCUS magazine, the University Hospital Rechts der Isar Munich ranks among the Germany's top medical institutions! Founded in 1834, the hospital combines long traditions and the very latest achievements of modern medicine. The medical facility includes 33 specialized departments, 20 interdiscipli
Endocarditis diagnosis
2200
Conservative treatment of endocarditis
6922
Pericardial drainage to treat endocarditis
19484

University Hospital Bonn

9.2/10
location_onGermany, Bonn

Department of Cardiology, Angiology and Pulmonology

According to the authoritative Focus magazine, the University Hospital Bonn ranks among the top ten medical facilities in Germany! The hospital was opened on January 1, 2001, although in fact it inherits the medical facility, which operated at the Faculty of Medicine of the University of Bonn. The hospital in Germany combin
Endocarditis diagnosis
2149
Conservative treatment of endocarditis
6975
Pericardial drainage to treat endocarditis
19590

University Hospital Muenster

9.8/10
location_onGermany, Muenster

Department of Cardiology

According to the Focus magazine, the University Hospital Muenster ranks among the top German hospitals! The hospital belongs to the most prestigious medical institutions in Germany. The hospital is distinguished by a high professionalism of its doctors, state-of-the-art technological equipment and the availability of the most ad
Endocarditis diagnosis
1889
Conservative treatment of endocarditis
6228
Pericardial drainage to treat endocarditis
17728
| from Booking Health GmbH

Endocarditis is an inflammation of the inner lining of the heart. The pathology is life-threatening, often leading to heart valve disease, stroke, pulmonary embolism and other complications. Half of the patients require surgical treatment of the disease. You can undergo endocarditis treatment abroad, in one of the countries with advanced medicine. European specialists successfully cope with even the most severe cases of pathology. They cure endocarditis with antibiotics and then repair or replace damaged heart valves with prostheses.

Content

  1. Causes of endocarditis
  2. Risk factors
  3. Symptoms
  4. Diagnostics
  5. Treatment
  6. Conservative therapy
  7. Surgical intervention
  8. Why is it worth undergoing treatment for endocarditis abroad
  9. Treatment in Europe at an affordable price

Causes of endocarditis

 

In most patients with endocarditis, the inner lining of the heart is affected by an infectious disease. The causative agents can be streptococci, staphylococci and other bacteria. The most severe endocarditis is fungal. The prognosis is worse for patients with fungal endocardial inflammation, because they always require surgical treatment.

Other causes of endocarditis are as follows:

  • Autoimmune inflammation.
  • Blood clots in the heart.
  • Hypereosinophilic syndrome.

Risk factors

 

The infection enters the heart from two sources: it is brought into the heart directly with a surgical instrument, or it comes from the blood.

Prosthetic valve endocarditis is an example of direct infection. Inflammation occurs after heart surgery.

Native valve endocarditis develops more often. The infection enters the bloodstream during injections, central vein catheterization, dental procedures. The risk of pathology is increased in injection drug addicts: their endocarditis is most often caused by Staphylococcus aureus living on the skin.

The following risk factors can cause the development of the pathology:

  • HIV and other immunodeficiencies.
  • Congenital heart defects.
  • Elderly and senile age.
  • Previous heart surgery and transcatheter procedures (valve replacement, pacemaker implantation).
  • Cancer.
  • Hypertrophic cardiomyopathy.
  • Valvular heart disease.

The risk of endocarditis is higher for patients with previous endocardial inflammation. The probability of recurrent pathology during life reaches 5%.

Symptoms

 

The symptoms of the early stage of the disease are nonspecific. The most common manifestation is an increased body temperature. This symptom is detected in 90% of patients. Other signs are loss of appetite and weight loss.

The classic symptoms of endocarditis described in the literature develop only in advanced cases. These include:

  • Appearance of seals on the fingers (Osler's node).
  • Red palms and soles (Janevier symptom).
  • Foci of hemorrhage in the eyes (Roth's spots) and under the nails.

Chest pain is not typical for endocarditis.

The following symptoms can be detected when examining a patient in a hospital:

  • Heart murmur (caused by heart valve disease).
  • Rapid pulse.

The first symptoms in many patients are neurological disorders caused by impaired cerebral circulation. Only after admission to a neurological hospital are they diagnosed with endocarditis.

In the natural course of the disease, if the patient does not seek medical help for a long time, endocarditis progresses rapidly. Within a few days, acute heart failure develops.

When the first symptoms appear, the patient should see a doctor as early as possible. As a rule, the patient is given antibiotic therapy immediately after admission to the hospital. After its initiation, the risk of complications of endocarditis is reduced by 2,5 times.

Diagnostics

 

The diagnosis of infective endocarditis is made according to Duke criteria. The diagnosis can be confirmed or probable. It is established on the basis of major and minor criteria. Endocarditis is considered confirmed with the following criteria available:

  • Two major criteria.
  • Three minors and one major.
  • Five minor ones.

There are several options, when a doctor can diagnose possible infective endocarditis:

  • One major and one minor criteria.
  • Three minor ones.

There are only two major criteria:

  1. The blood culture reveals bacteria or fungi, which can be the causative agents of infective endocarditis.
  2. The instrumental tests detect the signs of endocardial lesions. The main methods are echocardiography (ultrasound examination) and computed tomography.

Minor Duke criteria:

  • Сardiovascular diseases in the medical history, which are predisposing factors for the development of infectious inflammation of the endocardium.
  • Multiple injections of medicines or drugs in the medical history.
  • Fever over 38 degrees.
  • Signs of autoimmune tissue inflammation.
  • Microbes are sown from the blood, but in insufficient quantities to ascertain the presence of a major criterion.
  • Any severe cardiovascular complications: stroke, pulmonary embolism, hemorrhage.

The instrumental diagnostics mostly involve the use of echocardiography. This is a safe examination without radiation exposure, which can be done every few days to monitor the patient's condition dynamically. Echocardiography is usually carried out through the chest. Less commonly, a transesophageal transducer is used. Such an examination causes discomfort in the patient, and therefore doctors in Europe perform it under drug sedation. Transesophageal ultrasound has a higher sensitivity – it reaches 95%. Doctors may find vegetations (growths on the heart valves) less than 5 mm in size.

Computed tomography can be used to diagnose the following conditions:

  • Lesions of the coronary arteries.
  • Complications of endocarditis – spleen infarction and stroke.

MRI is used to assess the state of the brain. 10% of patients with endocarditis have abscesses (purulent cavities), aneurysms or hemorrhages. Another 50% show signs of impaired blood supply to the brain, which are not accompanied by significant symptoms and do not lead to neurological deficit.

PET (positron emission tomography) is a clarifying diagnostic test, which is performed for suspected infective endocarditis.

An important role in diagnostics is also played by a microbiological examination. Doctors perform a blood culture to detect the causative agent of the infection, assess the number of bacteria and determine their sensitivity to various antibiotics. Culture results are diagnostic criteria and will influence the choice of treatment regimen.

Treatment

 

In European hospitals, the treatment of infective endocarditis is provided by a team of doctors comprised of a cardiologist, a cardiac surgeon, a specialist in infectious diseases, sometimes also a rheumatologist, a neurologist and a neurosurgeon (brain complications develop in one out of four patients with endocarditis). The management of patients by several doctors significantly improves the prognosis, and therefore such an approach is considered mandatory in developed countries.

The mainstay of treatment for infective endocarditis is antibiotic therapy. Even with successful suppression of the infection, approximately half of patients will require a surgical intervention.

Conservative therapy

 

The treatment of infective endocarditis involves the use of antibiotics. At first, it is empirical therapy, which means that doctors simply prescribe broad-spectrum medications that can destroy most of the most common causative agents of endocarditis.

After 2 days, the specialists in infectious diseases receive a medical report from the bacteriological laboratory. Now they not only know the causative agent of the infection, but also have data on the sensitivity of microorganisms to various antibiotics. After receiving these data, the antibiotic regimen can be adjusted.

Antibiotic therapy for endocarditis takes a long time. The medicines are not canceled 4-6 weeks after all symptoms have disappeared. If treatment is stopped earlier, endocarditis is very likely to recur.

Surgical intervention

 

Indications for surgery are as follows:

  • Fungal etiology of the disease.
  • Uncontrolled infection.
  • Progression of the disease due to antibiotic therapy.
  • Abscesses (cavities with pus) in the heart.
  • Severe heart valve insufficiency affecting any valve.
  • Prosthetic valve endocarditis.

Whenever possible, a heart surgical intervention is performed after elimination of the focus of infection and stabilization of the patient's condition. Ideally, patients are operated on 2 weeks after completing antibiotic therapy.

However, this is not always possible, since in some cases life-threatening conditions arise, which require emergency surgery. Some patients are operated on even on the first day after hospitalization. Emergency surgical interventions are not always successful and have a high risk of death. Therefore, they are resorted to only in extreme cases, such as severe acute heart failure, uncontrolled infection or the threat of cerebral embolism. Most emergency operations are performed for heart failure caused by destruction of the leaflets of the aortic or mitral valves.

The tasks of the surgeons are to eliminate inflammation and repair the heart valves. Doctors remove inflamed tissue in the heart. Small cavities with pus are cleaned and sutured, large abscesses are drained. A pathway is usually formed for the outflow of inflammatory fluid into the pericardial cavity.

The heart valves are repaired, and if reconstruction is not possible, then they are replaced with prostheses. As a rule, only mitral or tricuspid valves can be repaired. The aortic valve is more often damaged as a result of endocarditis and it cannot be reconstructed. It is replaced with a prosthesis.

The mitral and tricuspid valves are located between the atria and ventricles – in the left and right half of the heart, respectively. In case of endocarditis, the mitral valve is more often affected. Both valves can be repaired. Doctors suture the leaflets or perform flap plastic surgery. Sometimes chords open. These are tendon filaments, which hold the valve leaflets. In this case, they are repaired: the doctor places threads from artificial materials.

If it is impossible to restore the valves, they are replaced with prostheses. Young patients often suffer from endocarditis, so mechanical prostheses are often placed in the mitral position. They require lifelong anticoagulant therapy, but can serve up to 30 years, and sometimes longer. Predominantly biological prostheses are placed in the tricuspid position, since mechanical ones contribute to the formation of blood clots. Bioprostheses are not so durable. After 10-15 years, they may need to be replaced. However, surgeons in developed countries perform revision replacement surgery using a minimally invasive access: through the vessels in the leg.

Why is it worth undergoing treatment for endocarditis abroad

 

Endocarditis is a serious disease, the treatment of which requires experienced specialists and state-of-the-art medical technology. In this disease, the risk of complications from the central nervous system, including ischemic stroke, is 25%. About 10% of patients develop pulmonary embolism. The need for surgical treatment occurs in 50% of patients. The mortality rate of patients with infective endocarditis reaches 30%.

Developed countries have 2-3 times lower mortality rate. Doctors successfully cure endocarditis and eliminate its consequences. There are several reasons for you to undergo medical treatment abroad:

  • Accurate diagnostics allows the doctors to determine the cause of endocarditis in order to ideally plan treatment.
  • The patient is led not by one doctor, but by the "endocarditis team".
  • The risk of death within 12 months is only 8%. The mortality rate of patients is 2 times lower than the world average and 4 times lower than in countries with poorly developed medicine.
  • Successful performance of even emergency (on the first day) and urgent (in the first week) surgical interventions.
  • Possible simultaneous replacement or reconstruction of several heart valves within a single surgical intervention.
  • In 80% of cases, the mitral valve is repaired, rather than replaced with a prosthesis – this operation is technically more complex, but provides better long-term results.
  • Revision replacement of the heart valves is performed with the use of minimally invasive methods: a new bioprosthesis is placed over the old one through an incision in the leg instead of open-heart surgery.

You can go to Europe not only for the treatment of endocarditis, but also to eliminate the consequences of the disease. The most common consequences are heart valve defects. They can be corrected on a scheduled basis, using surgical interventions or minimally invasive procedures.

Treatment in Europe at an affordable price

 

To undergo treatment in one of the European hospitals, you can use the services of the Booking Health specialists. On our website, you can see the cost of treatment in Europe, compare prices and book a medical care program at a favorable price. Treatment in Europe will be easier and faster for you, and the cost of treatment will be significantly lower.

You are welcome to leave your request on the Booking Health website. Our consultant will contact you within 24 hours. The medical tourism operator form the Booking Health company will organize your trip for medical treatment in Europe. We will provide the following benefits for you:

  • We will choose a hospital for treatment in Europe, whose doctors specialize in the treatment of endocarditis and achieve the best results.
  • We will help you overcome the language barrier and establish communication with your attending physician.
  • We will reduce the waiting time for the medical care program. You will receive medical services on the most suitable dates.
  • We will reduce the price. The cost of treatment in a European hospital will be lower due to the lack of overpricing and additional coefficients for foreign patients.
  • We will solve all organizational issues, such as paperwork, booking a hotel room, transfer from the airport to the hospital. An interpreter will accompany you abroad.
  • We will prepare a program and translate medical documents. You do not have to repeat the previously performed diagnostic procedures.
  • We will help you keep in touch with the hospital after the completion of treatment in Europe.
  • We will organize additional diagnostic examinations and treatment in a European hospital, if required.
  • We will buy medicines abroad and forward them to your native country.

The world's leading doctors will take care of your health. The Booking Health specialists will help reduce the cost of treatment, organize your trip, and you will only have to focus on restoring your health.

Authors: Dr. Nadezhda IvanisovaDr. Farrukh Ahmed




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