What is Endocarditis?

Endocarditis is a rare infection of the inner lining of the heart (endocardium) and the
heart valves, usually caused by germs (or, less commonly, fungus) entering the bloodstream
and passing into the heart.^[1] However, a rare, non-infective variant also exists. Non-infective
endocarditis is a build-up of clots on the endocardium or cardiac valves, caused by certain
medical conditions, including some types of cancer, pregnancy, and trauma.^[2]

Endocarditis treatment will usually involve a course of antibiotics and – in rare cases,
usually when complications arise – surgery. If left untreated, the condition can cause severe
damage to the heart and result in life-threatening complications. Early diagnosis is critical
to improving the prognosis of those with endocarditis.^[3]

Symptoms of endocarditis

Symptoms of endocarditis may include:^[4]

• Fever and chills
• Fatigue and night sweats
• Loss of appetite
• Weight loss
• Generally feeling unwell
• Pain in the muscles or joints
• Shortness of breath and coughing
• Chest pain when breathing
• Swelling of the legs, ankles or feet

Less common symptoms may include:

• Blood in the urine
• Tenderness in the upper half of the abdomen
• Red spots on the hands or feet
• Red-purple bumps under the skin of the toes or fingers (Osler’s nodes)
• Small red or purple spots on the skin, inside the mouth or on the whites of the eyes
• Back pain

Non-infective endocarditis will generally present fewer symptoms than infective endocarditis.

and they are unlikely to develop until the later stages of the condition or when complications
arise. Symptoms of infective endocarditis can either develop slowly or rapidly (in a number
of days) depending on what kind of bacteria or fungi is causing the condition.

Complications can develop quickly, making the condition more difficult to treat. For this
reason, it is important to see a doctor early when worrying symptoms occur. If you are experiencing symptoms or feel unwell, contact your doctor’s Find My doctor location to do a symptom assessment at any time.

Causes of endocarditis

Endocarditis most often occurs in people with preexisting heart disease (which maybe
diagnosed or undiagnosed) and less commonly in people with normal hearts.

Endocarditis may occur when bacteria or fungi enter the bloodstream through small injuries
(such as those experienced during teeth cleaning), when injected into the veins, during
surgery, or as a result of other infections. If the bacteria or fungi reach the heart, they
may settle on the endocardium (the heart’s inner lining or valves) and begin to grow – causing
an infection.

Ordinarily, the immune system is able to clear bacteria and fungi that enter the bloodstream.
When this does not happen, however, some bacteria or fungi can settle on the endocardium or
valves of the heart (especially likely if a valve is already damaged in some way) and form
small growths (vegetations). These growths can prevent the heart from functioning correctly
and may break off and infect other areas of the body.

While endocarditis is a rare condition, the following groups are most at risk:^[5]

• People with previously damaged heart valves or an artificial heart valve
• Users of injected drugs such as heroin

It should also be noted that any procedure that requires placing medical devices into the
veins or any type of heart surgery can also be a risk factor.

Those most at risk of non-infective endocarditis include people with the following conditions:^[6]

• Systemic lupus erythematosus
• Antiphospholipid syndrome
• Stomach cancer, lung cancer or pancreatic cancer

If you are feeling unwell, You can search for a doctor near you My Doctor at any time.

Diagnosing endocarditis

If a diagnosis of endocarditis is suspected based on the symptoms and medical history, a
thorough physical examination will be carried out, paying particular attention to the heart.^[7]
In particular, doctors will listen for heart murmurs (unusual sounds from the heart), which
can be an indicator of the condition. A doctor will in most cases then also order a series
of tests to confirm the diagnosis.

Blood tests will be ordered in order to identify any bacteria or fungi present in the blood.
An ultrasound of the heart may also be able to show signs of any abnormal growths on the
heart valve, as well as any damage to the heart. Further diagnostic tests (X rays, CT scan, MRI,
ECG) can also be carried out to investigate any involvement in other organs.^[8]

If blood tests reveal no sign of infection but other symptoms and risk factors are present,
the diagnosis of non-infective endocarditis may still be possible.^[9]

Endocarditis treatment

Many cases of (infective) endocarditis can be effectively treated with antibiotics or
antifungal medication. If the growth is very large, or if there is new or pre-existing
damage to the heart, surgery may be required.^[10]

Antibiotics

As soon as possible after diagnosis, an individual with infective endocarditis will be treated
with antibiotics, usually intravenously (through a drip). The course will last for several
weeks, a period through which most people will be required to stay in hospital.

If an individual continues to feel unwell after a number of days of treatment using antibiotics,
or if new symptoms occur, it is important to inform a doctor.

Surgery

If the endocarditis causes severe damage to the heart, or infections are persistent, surgery
may be necessary. The goal is generally to repair a damaged valve or replace a valve entirely.
Surgery can be life-saving, but it is a risky procedure with possible complications.

Treating non-infective endocarditis

Treatment for non-infective endocarditis generally involves treating the underlying condition
that is its cause. Drugs to prevent the formation of new blood clots may be prescribed, but
this will depend on the doctor and the underlying causes of the condition.^[11]

Endocarditis complications

Complications will generally arise if endocarditis is left untreated or if it is treated too late.

The two most serious complications of endocarditis are heart failure and sepsis. If growths in the heartbreak up and spread to other areas of the body, complications including abscesses, strokes, and – in some cases – seizures are possible. Heart failure, sepsis, and seizures are all medical emergencies and if they occur, the affected person should receive medical assistance as soon as possible.

Endocarditis prevention

To help prevent endocarditis, it is important – especially for those who are particularly vulnerable
to the disorder – to be aware of its signs and symptoms. Through this awareness, if any signs or
symptoms occur, it will be possible to seek medical assistance without delay.

It is also important to maintain high standards of dental hygiene and to receive regular checkups
from a dentist. This will help prevent any bacteria from the mouth from passing into the bloodstream.
Individuals should also avoid getting tattoos and piercings – activities that can lead to infection.

People with a known high risk of developing endocarditis may also be given preventative antibiotics
before dental or medical procedures. This decision, however, is left to the discretion of the doctor
or dentist.^[12]

Users of injected drugs (such as heroin) should use only sterile syringes, needles, and other apparatus,
and never share syringes with others in order to reduce the risk of infection.

Endocarditis prognosis

Early diagnosis and treatment can improve the prognosis for endocarditis, with many people recovering
after receiving appropriate treatment. If left untreated, however, the condition often becomes
life-threatening. Older people, those with a particularly resistant infection, those with particularly
large growths, and those with underlying medical conditions have a higher probability of experiencing
complications as a result of the condition.^[13]

The prognosis for those with non-infective endocarditis is dependent on the underlying medical condition
that is the cause of the condition.^[14]

Endocarditis FAQs

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1. HealthHype. “Endocarditis (Infective and Noninfective) Causes and Symptoms” Accessed August 18, 2017. ↩

2. News Medical. “Non-Infective Endocarditis.” Accessed August 18, 2017. ↩

3. NHS Choices. “Endocarditis.” March 24, 2016. Accessed August 18, 2017. ↩

4. Mayo Clinic. “Endocarditis – Symptoms and causes.” July 15, 2017. Accessed August 18, 2017. ↩

5. Patient. “How does endocarditis occur and progress?” August 1, 2017. Accessed August 18, 2017. ↩

6. MSD Manual. “Noninfective Endocarditis.” Accessed August 18, 2017. ↩

7. NHS Choices. “Endocarditis – Diagnosis.” March 24, 2016. Accessed August 18, 2017. ↩

8. Mayo Clinic. “Endocarditis – Diagnosis.” July 15, 2017. Accessed August 18, 2017. ↩

9. MSD Manual. “Noninfective Endocarditis.” Accessed August 18, 2017. ↩

10. Mayo Clinic. “Endocarditis – Treatment.” July 15, 2017. Accessed August 18, 2017. ↩

11. MSD Manual. “Noninfective Endocarditis.” Accessed August 18, 2017. ↩

12. Mayo Clinic. “Endocarditis – Self-management.” July 15, 2017. Accessed August 18, 2017. ↩

13. MSD Manual. “Infective Endocarditis.” Accessed August 21, 2017. ↩

14. MSD Manual. “Noninfective Endocarditis.” Accessed August 21, 2017. ↩

15. Patient. “Prevention of Infective Endocarditis.” September 22, 2015. Accessed September 8, 2017. ↩

**What​ is Endocarditis?**



**Question:** What is Endocarditis?



**Answer:** Endocarditis ​is a rare but serious ⁢infection of the‌ inner lining of the heart, called the endocardium. It can also affect the ‌heart valves. Bacterial endocarditis ⁢(IE) is caused predominantly by bacteria. Fungal endocarditis is ⁢a much rarer type, most commonly associated ⁢with immunocompromised patients.



**Keywords:** Endocarditis, Heart Infection, Heart Lining, Heart Valves, Bacterial Endocarditis, Fungal Endocarditis



**Symptoms of Endocarditis**



**Question:** What are ⁢the symptoms of‍ endocarditis?



**Answer:** Symptoms⁣ of endocarditis can vary depending on the underlying cause and severity of infection. Possible ‌symptoms include:



* Fever, chills, and fatigue

* ⁢Night sweats

* Shortness of breath

* ⁣Chest pain

*​ Joint pain

* ‌Rash on the hands or ​feet

* Weight loss



**Keywords:** Endocarditis Symptoms, Fever, Fatigue, Shortness of Breath, Chest Pain



**Causes of Endocarditis**



**Question:** What causes endocarditis?



**Answer:** Endocarditis is typically caused by bacteria entering the bloodstream and infecting the heart valves ⁣or‌ inner lining of the heart. Common risk factors include:



* Dental work or other procedures that can cause bacteremia⁣ (presence of bacteria in the blood)

* Valve abnormalities, such ​as congenital heart defects

* Weakened immune system

* Intravenous drug‌ use



**Keywords:** Endocarditis ​Causes,​ Bacteremia, ‍Dental Procedures, Heart Defects, Immune Deficiency



**Diagnosis of⁤ Endocarditis**



**Question:**‌ How is ⁢endocarditis diagnosed?



**Answer:** Endocarditis is diagnosed based⁤ on symptoms,⁢ physical examination,⁣ and diagnostic tests, such as:



* Blood cultures to ‌detect the presence‍ of ‍bacteria

* echocardiogram (imaging test) to examine the​ heart valves

* MRI or CT scans



**Keywords:** Endocarditis ⁤Diagnosis, Blood Culture, Echocardiogram, MRI, CT Scans



**Treatment of Endocarditis**



**Question:** How is endocarditis treated?



**Answer:** Treatment for endocarditis often involves long-term ​antibiotic therapy and sometimes requires heart surgery.



* **Antibiotic ​therapy:** High doses of antibiotics administered intravenously to kill the infection.

* **Surgery:** May⁢ be needed to repair or replace ​damaged heart valves or remove ⁣infected tissue.



**Keywords:** Endocarditis‍ Treatment, Antibiotics, Heart Surgery



**Prevention of Endocarditis**



**Question:** How can⁢ I prevent endocarditis?



**Answer:** While not⁢ all cases of endocarditis are preventable, certain measures can reduce the risk, ‍including:



* Maintaining good oral hygiene

* Promptly treating dental infections

* Informing healthcare providers about ​previous episodes of endocarditis or heart valve surgery

* Avoiding high-risk activities, such as intravenous drug use



**Keywords:** Endocarditis Prevention, Oral Hygiene, Dental Infections, Healthcare Communication



By understanding the causes, ​symptoms, diagnosis, treatment, and prevention of endocarditis, we can better protect against this serious heart‌ infection.