Heart Infection (Endocarditis)

What is endocarditis?

Endocarditis is an infection of the endocardium inside the heart. The endocardium is the thin layer of tissue lining the inside of the heart.

The infection is caused by bacteria, yeast, or fungi that attach themselves to the lining. Usually they infect the heart valves. They grow there, damaging the valves.

How does it occur?

You are more at risk for endocarditis if you have had endocarditis before or if you have:

• heart valve damage from rheumatic fever
• some types of birth defects in the heart
• some types of heart valve abnormalities
• an artificial heart valve.

The most common ways bacteria or other organisms can get into the heart are:

• during dental procedures
• from an open wound
• from shared needles during drug use
• during some surgical and diagnostic procedures.

Endocarditis may happen if you have IV tubes in the hospital, especially if you need the tubes for more than a day or two.

What are the symptoms?

The most common symptoms are:

• fever
• sweats
• chills
• loss of appetite
• tiredness
• weight loss
• joint and muscle pain.

At first the infection may be mistaken for the flu, but the symptoms usually get worse with time.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. You may have some tests.

• Echocardiography uses ultrasound pictures of your heart to look for infection of the heart valves. A transesophageal echocardiogram (TEE) is a type of echocardiogram taken through a small tube passed down your esophagus. This view can give the clearest picture of areas of infection.
• Blood samples will be tested for infection and to see what kind of organism is causing it.

How is it treated?

You will have to stay at the hospital for a while. You will take antibiotics for several weeks.

You may need to have surgery right away if the antibiotics cannot get rid of the infection or if one of the heart valves is badly damaged.

How long do the effects last?

If a heart valve has been badly damaged by the infection, your heart has to work harder and may get bigger. You may not be able to exercise as much as you used to. Badly damaged valves may be treated with valve replacement surgery.

The infection could travel from the heart to other parts of the body, causing other problems, such as stroke or damage to the kidneys.

If you have an artificial heart valve and get endocarditis, the infected valve must usually be replaced with a new one.

How can I help prevent endocarditis?

Damaged, abnormal, or artificial valves are more likely to get infected by bacteria. Antibiotics can prevent this. Ask your healthcare provider if you should take an antibiotic before any kind of dental work or surgery. This includes having your teeth cleaned or procedures involving the bladder, vagina, or rectum.