Endocarditis is an infection of the heart valves and the endocardium. The endocardium is the inner lining of the heart muscle.

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.)

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• 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, and perform a physical exam. The doctor will check your heart for unusual heart sounds (called murmurs).

Tests include:

• Blood Tests – to check for infection

• Echocardiogram – a test that 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 are at risk for endocarditis during certain medical procedures, take antibiotics before the procedure. Medical conditions that require this preventive antibiotic therapy include:

• • Heart defects

• • Artificial heart valves

• • History of endocarditis

• Never use illegal intravenous drugs.

RESOURCES:

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

Medline Plus
http://medlineplus.gov

References:

Braunwald E, Zipes DP, Libby P, et al. Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. Philadelphia, PA: W.B. Saunders Company; 2001.

Cecil RL, Goldman L, Bennett JC. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: W.B. Saunders Company; 2000.

Rakel RE and Bope ET. Conn's Current Therapy 2001. 53rd ed. Philadelphia, PA: W.B. Saunders Company; 2001.