Endocarditis

Overview

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

Factors that may increase your chances of 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

SymptomsandDiagnosis

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 called heart murmurs .

Tests include:

  • Blood tests
  • Echocardiogram

Treatments

Treatment

Treatment may include:

  • Antibiotics—given by IV 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 defects
  • Artificial heart valves
  • History of endocarditis
  • Heart transplant recipients who have developed valve disease

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

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

RESOURCES

American Heart Association http://www.heart.org 

Mouth Healthy—American Dental Association http://www.mouthhealthy.org 

CANADIAN RESOURCES

Canadian Dental Association http://www.cda-adc.ca 

Heart and Stroke Foundation of Canada http://www.heartandstroke.ca 

References

Infective endocarditis. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Infective-Endocarditis%5FUCM%5F307108%5FArticle.jsp#.Wh8q3lWnHIU. Updated September 29, 2017. Accessed November 29, 2017.

Infective endocarditis. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T113919/Infective-endocarditis . Updated November 22, 2017. Accessed November 29, 2017.

12/17/2015 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T113919/Infective-endocarditis : Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis. Guidelines from the American Heart Association. Circulation. 2007;116(15):1736-1754.