Definition

The endocardium is the inner lining of the heart muscle. Endocarditis is an infection of this lining and the heart valves.

Causes

Causes of endocarditis include:

  • Bacterial infection, which is the most common cause
  • Viral or fungal infection
  • Medical conditions that result in blood clotting too easily, causing a noninfectious form

Endocarditis

Risk Factors

Factors that increase your risk of getting endocarditis include:

  • Having an artificial heart valve
  • History of endocarditis
  • History of rheumatic fever, which can damage heart valves
  • Heart defects
  • Enlarged heart
  • Mitral valve prolapse
  • History of IV drug use
  • Recent procedures that can lead to bacterial endocarditis, including:
    • Tooth cleaning
    • Tonsillectomy and adenoidectomy
    • Bronchoscopy
    • Surgery on the gastrointestinal, urinary, or respiratory tracts
    • Gallbladder or prostate surgery

Symptoms

Symptoms of endocarditis include:

  • Fever, chills
  • Weakness, low energy
  • Sweatiness, especially at night
  • Shortness of breath
  • Cough
  • Loss of appetite, weight loss
  • Chest pain
  • Abdominal pain
  • Nausea and vomiting
  • Painful red bumps on the fingers and toes
  • Purple dots on the whites of the eyes, under the fingernails, and over the collarbone
  • Painful red patches on the fingers, palms, and soles

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will check your heart for unusual heart sounds. These are calledheart murmurs.

Tests include:

  • Your bodily fluids may be tested. This can be done with blood tests.
  • Your heart may be examined. This can be done with echocardiogram.

Treatment

Treatment may include:

  • Antibiotics—given through your veins for up to 4-8 weeks
  • Surgery—to repair or replace the valve if it is severely damaged or has caused heart failure

Prevention

If you have a high risk of infection:

  • You may need to take antibiotics before certain dental or medical procedures.
  • Talk to your dentist or doctor before the procedure.

The American Heart Association guidelines recommend that preventive antibiotic therapy should be considered for individuals with the following cardiac conditions:

  • Various forms of congenital heart disease—heart defects
  • Artificial heart valves
  • History of endocarditis
  • Heart transplant recipients who have developed valve disease

Avoiding illegal IV drugs will also decrease your risk of infection.

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