Dr. Pham Do Anh Thu, head of the Heart Valve Unit at Tam Anh General Hospital in TP HCM, explained that infective endocarditis is an inflammation of the heart's inner lining caused by bacteria or fungi, usually occurring in the heart valves. Infective endocarditis directly destroys the physical structure of the heart valve, making it unable to close tightly, causing more severe leakage. Bacteria that infect the heart valves often come from oral infections, skin infections, or unsterile medical procedures. These bacteria enter the bloodstream, travel to the heart, and develop into corrosive vegetations.

While managing his condition at home, Tu did not have regular dental checkups, which led to a heart valve infection and worsened his condition. After examination, doctors diagnosed infective endocarditis caused by bacteria from the oral cavity. The bacteria colonized the heart valve, forming vegetations (a combination of bacteria and blood clots) that triggered a systemic inflammatory response, manifesting externally as a fever.

Tu was hospitalized with an enlarged heart chamber and symptoms of heart failure. His mitral valve was severely leaking, causing a large amount of blood to flow back into the left atrium each time the heart contracted. To compensate, the left ventricle had to work harder, pumping an increasing volume of blood, eventually leading to heart failure.

Doctors performed valve repair surgery to preserve the natural valve, ensure heart function, and reduce the risk of long-term complications. Because the patient had long-term heart failure and valve leakage, the valve annulus was dilated, requiring the doctor to implant an artificial valve annulus. He was discharged after three days and needs regular follow-up appointments.

Dr. Thu said most cases of bacterial endocarditis can be linked to oral hygiene. Patients need proper oral care and regular dental checkups to prevent and detect inflammatory issues in the oral cavity early.

Dr. Thu examines Tu during a follow-up appointment. Photo: Tam Anh General Hospital

Dr. Thu examines Tu during a follow-up appointment. Photo: Tam Anh General Hospital

Mitral regurgitation occurs when the mitral valve doesn't close completely during heart contractions, causing blood to flow back into the left atrium instead of being pumped to the body. The causes can be primary (due to infective endocarditis, mitral valve prolapse, valve degeneration, rheumatic heart disease, congenital heart disease, etc.) or secondary (due to dilated cardiomyopathy, coronary artery disease, heart attack, etc.).

Mild mitral regurgitation often has no symptoms. When the condition becomes moderate to severe, patients may experience fatigue, shortness of breath, rapid heartbeat, palpitations, dry cough, leg swelling, and reduced exercise capacity. Treatment depends on the severity of the leakage and the underlying cause. Mild cases may only require regular checkups to monitor the progression of the disease or medication as prescribed. In severe cases, doctors may recommend mitral valve repair surgery to preserve the natural valve. If the valve is too damaged, the patient may need an artificial valve replacement.

To prevent the disease, follow a low-sodium diet to control blood pressure and reduce water retention. Eat plenty of green vegetables, fruits, and whole grains. Engage in light exercise such as walking, yoga, or slow cycling, and avoid overexertion. Maintain a healthy weight, avoid smoking and alcohol, and attend regular checkups as scheduled.

Dinh Lam