Infectious heart disease death rates rising again say scientists

September 11, 2008

Infectious heart disease is still a major killer in spite of improvements in health care, but the way the disease develops has changed so much since its discovery that nineteenth century doctors would not recognize it, scientists heard today (Thursday 11 September 2008) at the Society for General Microbiology's Autumn meeting being held this week at Trinity College, Dublin.

Infective endocarditis is a devastating, progressive and frequently fatal heart disease usually caused by bacterial pathogens. It was first identified in the nineteenth century and has changed beyond all recognition due to evolution of the disease itself and developments in modern healthcare such as open-heart surgery, antibiotics and new medical imaging techniques.

"In spite of these medical advances, infective endocarditis is still evolving and we are seeing new patterns of the disease and its complications. Despite all our improvements in health care, the death rate has been virtually unchanged for the last 20 years, and now seems to be rising again," said cardiologist Dr Bernard Prendergast from the John Radcliffe Hospital in Oxford, UK.

"In the nineteenth century rheumatism affecting the heart valves was the most common form of heart disease and the usual target for infective endocarditis. Now that people live so long, degenerative heart valve disease is a more common problem. We're also seeing complications in patients who have received replacement heart valves and infections as a result of intravenous drug use," said Dr Prendergast. "On top of that, aggressive Staphylococcus infections are now common, and conventional antibiotic treatments are becoming less effective because of drug-resistant bacteria".

Early surgery to treat valve infection would probably save many lives. However, the operations needed are often tricky and high risk because patients are extremely sick at the time of surgery. For this reason, the timing of the operation can be difficult and expert care is essential.

A second controversy is whether patients with valve disease can be protected from the risk of infection at the time of routine procedures such as dental work by using preventative antibiotic treatment. While this has been traditional practice, recent assessment by the government watchdog NICE, has suggested that this practice is obsolete, although this recommendation is in conflict with the position in the USA and Europe.

"It's an impossible and continuing debate, fueled by fundamental differences in international guidelines," said Dr Prendergast. "We just don't have the results from properly conducted and randomized clinical trials to know whether routine prophylactic antibiotics are helpful or not. Greater awareness of the dangers of infective endocarditis amongst both doctors and patients is certainly essential and improved dental health and skin hygiene are probably at least as important as blanket antibiotic treatment. As the disease evolves even further this debate could run on for years with heart physicians, microbiologists and surgeons all having different opinions. This is very unhelpful and confusing for patients."

Society for General Microbiology

---

---

	Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure by Caldwell B. Esselstyn Jr. (Author) A powerful call for a paradigm shift in heart disease therapy. Based on the groundbreaking results of a twenty-year nutritional study by Dr. Esselstyn, a preeminent researcher and clinician, this book illustrates that a plant-based, oil-free diet can not only prevent and stop the progression of heart disease but can also reverse its effects. The proof lies in the incredible outcomes for patients who have followed Dr. Esselstyn's program, including a number of patients in his original study who had been told by their cardiologists that they had less than a year to live. Within months of starting the program, Dr. Esselstyn's patients began to improve dramatically, and twenty years later, they remain free of symptoms. Complete with more than 150...
	Heart Disease Prevention and Reversal: How To Prevent, Cure and Reverse Heart Disease Naturally For A Healthy Heart by John McArthur Heart Disease Prevention and Reversal: How To Prevent, Cure and Reverse Heart Disease Naturally. The information in this guide has been compiled from the research of 50 world renowned leading heart doctors and scientists. This is what you will find inside: Why Conventional Treatments Won't Cure Heart Disease Cholesterol Reduction Drugs Are Causing Serious Side Effects And Deaths!Bypass Surgery And Angioplasty Maybe UnnecessaryThe Hard Plaque Blunder - Atherosclerosis What You MUST Do To Cure, Prevent And Reverse Heart Disease Quickly Clear Out Your Arteries Quickly - No Surgery Or Drugs Eat To Cure, Prevent And Reverse Heart Disease - No Starvation DietsControl Cholesterol Naturally - No Starvation DietsCrucial Vitamins, Minerals And Herbs That You MUST...
	Reverse Heart Disease Now: Stop Deadly Cardiovascular Plaque Before It's Too Late by Stephen T. Sinatra (Author), James C. Roberts (Author), Martin Zucker (Contributor) While most books focus solely on the role of cholesterol in heart disease, Reverse Heart Disease Now draws on new research that points to the surprising other causes. Two leading cardiologists draw on their collective fifty years of clinical cardiology research to show you how to combine the benefits of modern medicine, over-the-counter vitamins and supplements, and simple lifestyle changes to have a healthy heart.
	What Your Doctor May Not Tell You about Heart Disease by Mark Houston (Author) Coronary heart disease has long been the number one killer in this country, and for decades, we have been told about five basic risk factors: elevated cholesterol, high blood pressure, diabetes, obesity, and smoking. But the truth is that heart disease is much more complex-- with close to 400 risk factors! In this innovative guide, Dr. Mark Houston helps readers discover the causes of heart disease, how to prevent and treat its debilitating effects via nutrition, nutritional supplements, exercise, weight management, and lays to rest to various myths (cholesterol is not the primary cause) based on scientific studies and medical publications. Readers will also learn how to indentify the risk factors most likely to endager them and construct an arsenal of non-pharmacological...
	Saving Women's Hearts: How You Can Prevent and Reverse Heart Disease With Natural and Conventional Strategies by Martha Gulati (Author), Sherry Torkos (Author) Mention the term "heart disease" and most people picture an overweight, middle-aged man. Yet the reality is that heart disease is the number one killer of women in North America, accounting for a third of all deaths in women and far surpassing the prevalence of breast cancer.Cardiologist Dr. Martha Gulati and holistic pharmacist Sherry Torkos separate the facts from the many myths surrounding heart disease and offer the latest information on both the conventional medical approach and the role of natural medicine in understanding this illness. Saving Women's Hearts examines the unique gender differences for women and provides valuable insight into the screening procedures, diagnosis, treatment options, and most importantly, prevention of heart disease. Written by the leading experts in...
	The Cure for Heart Disease: Truth Will Save a Nation English Edition by Dwight Lundell (Author), Todd R. Nordstrom (Editor), Sarah Loukota (Editor) The Cure for Heart Disease, although written in everyday language, is different than every other book exploring the number one killer of Americans. A riveting yet straight forward discussion that challenges public consensus, explains the reasons for the epidemic of heart disease, and provides an easy to follow guide to eliminate heart disease and reduce the risk of heart attach and other debilitating diseases.
	Pathophysiology of Heart Disease: A Collaborative Project of Medical Students and Faculty (PATHOPHYSIOLOGY OF HEART DISEASE (LILLY)) by Leonard S. Lilly (Author) Revised and updated for its Fifth Edition, Pathophysiolgy of Heart Disease is a comprehensive, clear, concise, and easy-to-understand introduction to cardiovascular diseases. This best-selling text is written by internationally recognized Harvard Medical School faculty and select medical students during their initial encounters with patients with heart disease. This edition has improved consistency of coverage and level of detail and enhanced illustrations. A companion website on thePoint will include the fully searchable text and audio heart sounds, plus an image bank for faculty. Features :NEW! conversion of approximately 20 1-color line drawings to 2-color to make more use of 2- color; NEW! redrawing of approximately 15 existing 2-color line drawings to improve quality and presentation...
	Heart 411: The Only Guide to Heart Health You'll Ever Need by Marc Gillinov M.D. (Author), Steven Nissen M.D. (Author) The definitive guide to heart health from two of America's most respected doctors at Cleveland Clinic, the #1 hospital for heart health in America. Are you one of the eighty-two million Americans currently diagnosed with cardiovascular disease—or one of the millions more who think they are healthy but are at risk? Whether your goal is to get the best treatment or stay out of the cardiologist’s office, your heart's health depends upon accurate information and correct answers to key questions. In Heart 411, two renowned experts, heart surgeon Marc Gillinov and cardiologist Steven Nissen, tackle the questions their patients have raised over their decades of practice: Can the stress of my job really lead to a heart attack? How does exercise help my heart, and what is the right...
	Take a Load off Your Heart: 109 Things You Can Actually Do to Prevent, Halt and Reverse Heart Disease by Joseph C. Piscatella (Author), Barry A. Franklin (Author) Increase the odds of living longer with this bold, broad approach to cardiac health. A medically up-to-the-minute and easy-to-implement program, Take a Load Off Your Heart sets our four key steps to cardiovascular fitness, from assessing risk to managing stress, from improving diet to making a habit of exercise. It demystifies predictive markers such as trigylcerides and Syndrome X, and offers 109 simple, practical lifestyle tips - #22 Breathe deeply, #96 Drink black tea, #3 Increase your HDL level, #54 Walk briskly, #75 Give up dieting - for preventing, stabilizing and, yes, reversing heart disease.
	Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 2-Volume Set: Expert Consult Premium Edition - Enhanced Online Features and Print, 9e (Heart Disease (Braunwald) (2 Vols)) by Robert O. Bonow MD (Author), Douglas L. Mann MD FACC (Author), Douglas P. Zipes MD (Author), Peter Libby MD (Author) Braunwald's Heart Disease remains your indispensable source for definitive, state-of-the-art answers on every aspect of contemporary cardiology. Edited by Drs. Robert O. Bonow, Douglas L. Mann, Douglas P. Zipes, and Peter Libby, this dynamic, multimedia reference helps you apply the most recent knowledge in molecular biology and genetics, imaging, pharmacology, interventional cardiology, electrophysiology, and much more. Weekly updates online, personally selected by Dr. Braunwald, continuously keep you current on the most important new developments affecting your practice. Enhanced premium online content includes new dynamic cardiac imaging videos, heart sound recordings, and podcasts. With sweeping updates throughout, and contributions from a "who's who" of global cardiology, Braunwald's...