Endocarditis
Pronounced: En-doh-kar-dite-iss
Definition
The endocardium is the inner lining of the heart muscle. Endocarditis is an infection of this lining and the heart valves.
Causes
Causes include:
- Bacterial infection (most common cause)
- Viral or fungal infection
- Medical conditions that result in blood clotting too easily (this causes a noninfectious form)
Bacterial Endocarditis

Risk Factors
Factors that increase your chance 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
Symptoms
Symptoms 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—to check for infection
- Echocardiogram —uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
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
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
Never use illegal IV drugs will also decrease your risk of infection.
RESOURCES:
American Heart Association
http://www.americanheart.org/
Heart Information Network
http://www.heartinfo.org/
CANADIAN RESOURCES:
Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/
University of Ottawa Heart Institute
http://www.ottawaheart.ca/
References:
Braunwald E, Zipes DP, Libby P, et al. Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. Philadelphia, PA: WB Saunders Company; 2001.
Cecil RL, Goldman L, Bennett JC. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
Rakel RE and Bope ET. Conn's Current Therapy 2001. 53rd ed. Philadelphia, PA: WB Saunders Company; 2001.
*Updated Prevention section on 5/16/2007 according to the following study, as cited by DynaMed's Systematic Literature Surveillance : Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis. Guidelines from the American Heart Association. Circulation. 2007 Apr 19. [Epub ahead of print]
Last reviewed February 2009 by Igor Puzanov, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.