Acute Infective Endocarditis in Children: Understanding the Pathological Changes

Acute infective endocarditis in children is a serious condition that primarily affects the heart's inner lining, known as the endocardium, as well as the heart valves and the inner surfaces of large blood vessels. One of the most notable pathological features of this disease is the formation of infected growths, referred to as vegetations, along the edges of the heart valves where they come into contact or close together.

Formation of Vegetations

These vegetations are typically soft and fragile in texture, making them prone to breaking off from the valve surface. When this occurs, the dislodged fragments can travel through the bloodstream and lodge in various organs, leading to complications such as organ infarction or the formation of multiple small abscesses.

Potential Organ Involvement

Commonly Affected Organs

Organs such as the liver, kidneys, heart, and spleen are particularly vulnerable to these embolic events. As a result, children suffering from acute infective endocarditis may experience a range of systemic symptoms depending on which organs are affected and the severity of the damage.

Severe Cardiac Complications

In more severe cases, the infection can cause significant damage to the heart valves, including ulceration and even perforation. These structural changes can compromise the normal function of the valves. Additionally, the infection may weaken or rupture the chordae tendineae—fibrous cords that anchor the heart valves—leading to acute valvular insufficiency.

Impact on Heart Function

Acute valvular insufficiency can result in sudden and severe heart dysfunction, as the valves are no longer able to properly regulate blood flow within the heart. This condition requires immediate medical attention and may necessitate surgical intervention to repair or replace the affected valve.