Endocarditis

What is Endocarditis

Endocarditis is an infection of the inner layer of the heart (endocardium) or an infection of the heart valves. Endocarditis can cause growths inside the heart or on the heart valves.

Over time, these growths can destroy heart tissue and cause heart failure or problems with heart rhythm. They can also cause stroke if they break away and form a blood clot in the brain. Early treatment offers the best chance for curing endocarditis and preventing complications.

7 Interesting Facts of Endocarditis

1. Infectious or noninfectious (eg, lupus, malignancy) development of cardiac vegetations usually involving cardiac valves
2. May present similarly with congestive heart failure; fever may be present
3. In contrast to patients with myocarditis, there may be evidence of major (arterial) embolization of vegetations as well as other classic stigmata of endocarditis such as Janeway lesions, conjunctival hemorrhage, Osler nodes, Roth spots; murmur is suggestive of endocarditis
4. Differentiate by clinical presentation and ancillary testing; cardiac imaging with echocardiogram differentiates conditions
5. Diagnosis of endocarditis is based on Duke criteria; blood cultures remain critical to diagnosis of infectious endocarditis

What are the causes?

This condition may be caused by:

• Germs that normally live in or on your body. The germs that most commonly cause endocarditis are bacteria.
• A fungus.

What increases the risk?

This condition is more likely to develop in people who have:

• A heart defect.
• Artificial (prosthetic) heart valves.
• An abnormal or damaged heart valve.
• A history of endocarditis.

Having certain procedures may also increase the risk of germs getting into the heart or bloodstream.

What are the signs or symptoms?

Symptoms of this condition may start suddenly, or they may start slowly and gradually get worse.

Symptoms include:

• Fever.
• Chills.
• Night sweats.
• Muscle aches.
• Fatigue.
• Weakness.
• Shortness of breath.
• Chest pain.
• Blood spots in the eyes.
• Bleeding under the fingernails or toenails.
• Painless red spots on the palms.
• Painful lumps in the fingertips or toes.
• Swelling in the feet or ankles.

How is this diagnosed?

This condition may be diagnosed based on:

• A physical exam. Your health care provider will listen to your heart to check for abnormal heart sounds (murmur). He or she may also use a scope to check for bleeding at the back of your eyes (retinas).
• Tests. They may include:
  • Blood tests to look for the germs that cause endocarditis.
  • Imaging tests. A chest x-ray, CT scan, or echocardiogram may be used to create an image of your heart. A type of echocardiogram called a transesophageal echocardiogram may be done to look at certain heart valves more closely.

How is this treated?

Treatment for this condition depends on the cause of the endocarditis. Treatment may include:

• Antibiotic medicines. These may be given through a tube into one of your veins (IV antibiotics) or taken by mouth. You may need to be on more than one antibiotic medicine.
• Surgery to replace your heart valve. You may need surgery if:
  • The endocarditis does not respond to treatment.
  • You develop complications.
  • Your heart valve is severely damaged.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider.Do notstop taking the antibiotic even if you start to feel better. You may need to be on intravenous antibiotics for several weeks.
• Do notuse IV drugs unless it is part of your medical treatment.

Lifestyle

• Do notget tattoos or body piercings.
• Practice good oral hygiene. This includes:
  • Brushing and flossing regularly.
  • Scheduling routine dental appointments.
• Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Limit alcohol intake to no more than 1 drink a day for nonpregnant women and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.

General instructions

• Let your health care provider know before you have any dental or surgical procedures. You may need to take antibiotics before the procedure.
• Tell all of your health care providers, including your dentist, that you have had endocarditis.
• Gradually resume your usual activities.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• Your symptoms do not improve.
• Your symptoms get worse.
• Your symptoms come back.

Get help right away if:

• You have trouble breathing.
• You have chest pain.
• You have symptoms of a stroke. These include:
  • Sudden weakness.
  • Numbness.
  • Confusion.
  • Trouble talking or understanding.
  • A severe headache.

Summary

• Endocarditis is an infection of the inner layer of the heart (endocardium) or heart valves. It is caused by bacteria or a fungus.
• Having certain heart conditions or procedures may increase the risk of endocarditis.
• Antibiotics are an important treatment for endocarditis. Take these medicines as told by your health care provider. Do notstop taking them even if you start to feel better.
• Tell all of your health care providers, including your dentist, that you have had endocarditis.