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Endocarditis


Topic Overview

The heart

What is endocarditis?

Endocarditis is an infection of the heart's valves or its inner lining (endocardium). It is most common in people who have a damaged, diseased, or artificial heart valve.

Endocarditis is caused by bacteria (or, in rare cases, by fungi) that enter the bloodstream and settle on the inside of the heart, usually on the heart valves. Bacteria can invade your bloodstream in many ways, including during some dental, surgical, and medical procedures. If you don't take care of your teeth, having your teeth cleaned or even brushing your teeth can cause bacteria to enter the bloodstream.

See a picture of endocarditisClick here to see an illustration..

What increases the risk for endocarditis?

If you have a normal heart, you have a low risk for endocarditis. But if you have a problem with your heart that affects normal blood flow through the heartClick here to see an illustration., it is more likely that bacteria or fungi will attach to heart tissue. Some health care procedures or implanted devices may raise your risk for endocarditis. This is because they can let bacteria or fungi enter your bloodstream.

You have a higher risk of endocarditis if you have:

Not all heart problems give you a higher risk of endocarditis. You do not have a higher risk if you have:

What can you do if you are at risk for endocarditis?

If you have certain heart conditions, getting endocarditis is even more dangerous for you. These heart conditions include:

If you have any of these heart conditions, you may need to take antibiotics before you have certain dental and surgical procedures. The antibiotics lower your risk of getting endocarditis. If you do not have these conditions, antibiotics are not likely to help you.

Procedures that may require antibiotics include:

  • Certain dental work or dental surgery.
  • Lung surgery.
  • Surgery on infected skin, bone, or muscle tissue.
  • Certain medical procedures, such as a biopsy.

Practicing good oral hygiene is especially important to prevent endocarditis if you are at risk.

Your doctor can give you a card to carry in your wallet. The card states that you may need preventive antibiotics before certain procedures.

What are the symptoms?

The symptoms of endocarditis progress as the bacteria or fungi grow in your heart. Vague, flu-like symptoms, such as a low-grade fever and fatigue, often occur first. Most people with endocarditis begin to have symptoms within 2 weeks after becoming infected with bacteria or fungi.

But a powerful strain of bacteria may cause symptoms to appear much faster, within a few days.

Symptoms include:

Although symptoms are vague and may not seem worth telling your doctor about, if they don't go away or if you know you are at risk for endocarditis, contact your doctor.

If endocarditis is not treated, the bacteria that cause endocarditis can form growths on or around the heart valves. The growths prevent the heart valves from opening and closing properly. This interrupts the normal blood flow through the valves and interferes with the heart's pumping action. Blood can leak backwards instead of being pumped forward. Over time, heart failure can develop, because your heart may not be able to pump enough blood to meet your body's needs.

Endocarditis can also cause other problems, including:

How is endocarditis diagnosed?

First your doctor will ask about your medical history and do a physical exam. If your doctor thinks that you may have endocarditis, he or she will check for signs of the infection, such as a heart murmur, an enlarged spleen, skin rashes, and bleeding under your nails.

Blood cultures will be done to check for bacteria in your bloodstream. And other tests, such as an echocardiogram, may be done to check your heart function and look at your heart valves.

It is important to treat endocarditis as soon as possible to avoid permanent damage to the heart muscle or heart valves.

How is it treated?

Antibiotics given through a vein (intravenously, or by IV) are the usual treatment for endocarditis. If your heart valves are damaged by the infection or if you have an artificial heart valve, surgery to repair or replace the valve may be needed. You may also need surgery if your endocarditis is caused by a fungus. If it is not treated, endocarditis can be fatal.

Frequently Asked Questions

Learning about endocarditis:

Being diagnosed:

Getting treatment:

Ongoing concerns:

Living with endocarditis:

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