Endocarditis

Endocarditis is an infection of the thin layer of tissue lining the inside of the heart muscle. The infection is caused by organisms (such as bacteria, yeasts, and fungi) that attach themselves to the lining, usually on the heart valves. They grow there, damaging the valves.

How does it occur?

You are more at risk for endocarditis if you have:

• previous heart valve damage from having had rheumatic fever
• some types of heart problems present from birth
• an abnormal heart valve caused by aging or breakdown of valve tissue
• had endocarditis before
• artificial heart valves

The most common ways bacteria can enter the blood are:

• during dental procedures
• after an injury with an open wound
• from shared needles during drug use
• during certain surgical and diagnostic procedures

Endocarditis may occur if you are hospitalized with IV tubes, especially if you need the tubes for more than a day or two.

What are the symptoms?

The most usual symptoms are:

• persistent fever
• sweats
• chills
• loss of appetite
• fatigue
• weight loss
• joint and muscle pains

How is it diagnosed?

Your doctor will take note of your symptoms and examine you. He or she may order the following tests to confirm diagnosis:

• Echocardiography uses ultrasound pictures of your heart structure to detect small areas of infection, called vegetations, attached to the heart valves.
• A transesophageal echocardiogram (TEE) is a special echo picture taken through a small tube passed down your esophagus. This view gives the clearest picture of the vegetation.
• Blood samples will be tested for infection and to identify the bacteria causing it. The vegetations on the valves give off a shower of bacteria into the bloodstream. However, if you have taken antibiotics during the 2 weeks before the blood test, identification may be delayed or impossible.

How is it treated?

You will take antibiotics for 4 to 6 weeks. You can usually take the last weeks of antibiotic treatment at home. You may need to have surgery right away if the antibiotics are not able to get rid of the infection or if one of the heart valves is severely damaged.

How long do the effects last?

Successful treatment of the infection may not be enough to restore normal health if a heart valve has been damaged too much. If the valve has been damaged too much, your heart has to work harder and may become enlarged. You may not be able to exercise as much as you used to. If this happens, you may benefit from valve replacement surgery.

If you have an artificial heart valve and get endocarditis, the infected valve must usually be replaced with a new one to be sure of a cure. If the treatment for endocarditis is not successful, you run the risk of a stroke or damage to the kidneys.

Can it be prevented?

Tell your health care provider or dentist if you are at risk for endocarditis. If you are at risk for the disease, consult your physician to take antibiotics before you have dental work or before tests to look into your bladder or rectum. The use of antibiotics before the procedures can prevent infection.

NextGen Patient Education Material