Endocarditis?

[Ch]

I am a 35 year old white female with MVP with minimal, or regurgitation, depending who is reading the echo.  In April I underwent a catheter ablation of an AV node accessory pathway to cure SVT that I have had since I was a child.  The ablation was uncomplicated and successful and I have been SVT free since (how nice!).

Unfortunately, I haven't felt quite "right" since the ablation.  I'm very athletic and have remained active, but I've been tired, and since June I have run a low grade fever (99.5 to 100) off and on, with periodic (once or twice a month for a couple of days) spikes in fever where I go up to about 103.  In August I had a fairly severe sinus infection, with fever near 103 for about a week.  (I didn't see my doctor before August.)  I have not had a fever (nothing above 99.5) since Christmas, but I still feel tired.  In September I started developing some chest discomfort that is aggravated by bending over and twisting my upper body.

I had a CBC, HIV, Sed rate, some test for lupus, and some test for arthritis in October.  All were normal except slight anemia.  I had an echo that didn't show any sign of pericarditis, or any vegetations. Chest CAT was normal, and a bone scan a couple of weeks ago showed "increased uptake" in the sternum area.  My doctor has suggested that the increased uptake is likely an indication of inflammation caused by injury, although
I may not know when I injured myself, and is probably not related to my other symptoms.  He plans to draw blood for cultures when my fever goes up again.

Even though my mitral valve is unlikely to predispose me to endocarditis, does anything about this sound like endocarditis, or any other ideas?  Any input would be appreciated.  Thanks in advance for your time.

[Cleveland Clinic, MD]

Dear Angie,

Dosen't sound like endocarditis to me but blood cultures are a good idea to rule this possibility out.  Has your doctor considered chronic fatigue syndrome or other rheumatologic disorders such as fibromyalgia?

[Carol Power]

I am 23 years old and live in scotland and i would like some advice and guideance with regards a couple of issues.

I was born with bicuspid valve, and at the age of 15 i contracted Endocarditis, which resulted in me undergoing Open Heart Surgery for an Aortic Valve replacement.  I have yearly follow up appointments and i am on long term Warfarin, i would like to know if when i go for a smear test i should have antibiotic cover?

I would also like some advice with regards to my condition although i am in talks with my gp and consultant cardiologist about it at present.  

Since my operation in 1992 i have felt my health could be better when I was 17 i was diagnosed Asthmatic but after my surgery i have been suffering breathlessness, when climbing hills and stairs to the point that i sometimes have to stop to rest, I cannot do any physical exertion with the acception of swimming as i find from time to time i suffer slight chest pain especially when running for a bus, My cardiologist says that although i have an artificial valve i should be able to live a normal life and although i do in many respects i feel that i should be healthier according to the drs my cardiologist has even said that i should be able to play rugby and neither be up nor down, last year i was told i had aortic stenosis, but after questionning this i was then told i do not have aortic stenosis i have a echocardiographic gradient, my condition has even stopped me from working full time i can only work part time, what i would like to know is, are these symptoms due to Asthma as all drs keep saying, i am worried that perhaps there is still an underlying congenital problem that has not been found yet, after all they did not find my bicuspid valve condition until i was 15 please could you help.

Thanks

Carol

[Lynn J]

My father had Rheumatic Fever as a child and at age 49 had surgery to replace his mitral valve.  14 years later he developed the symptoms of endocarditis such as fever, night sweats, loss of appetite, chronic flemmy cough and nauseated stomach.  The Dr's took over six weeks to diagnose the endocarditis since he also had Non Hodgkins Lymphoma cancer and the symptoms apparently masked each other.  There was no vegetation to the heart although the mitral had some damage and the upper chambers were leaking.  The Cardiologist put him on a course of antibiotics for a six week period and said his outlook was good. My father died suddenly without any warning to anyone.
Although he did experience shortness of breath and fluid retention during the few days prior.  Did he get the endocarditis from having the valve starting to leak or did it develop from some secondary infection or strep elsewhere?  Does NHL cancer have some connection with mitral valve prosthetis?  What, in your best estimation, could have gone wrong with his heart that it stopped so suddenly?  He passed away in 1996 and were not provided with any medical opinion from the Dr and now would really appreciate any opinion on why he passed on.  Thanks.