(IE; Bacterial Endocarditis; Fungal Endocarditis)
by Michael Jubinville, MPH
Infective endocarditis (IE) is an infection of the inner surface of the heart. It is common for IE to develop on the heart valves. IE can be a life-threatening infection. It can also cause lasting damage to the heart. This can lead to health problems later on, such as heart failure.
Clumps of bacteria can also form in the heart with IE. These clumps can break off and travel through the blood to other areas of the body. It may block blood flow to important organs such as the brain, kidneys, or lungs.
IE may be caused by:
The germs may be part of the normal environment in your mouth or on your skin. However, a cut in the mouth or skin will allow the germs to enter the blood. When the germs reach the heart, they stick to a surface. There, they can grow and damage nearby tissue. Certain conditions can make it easier for germs to stick in the heart:
The risk of IE is higher with:
Symptoms range from mild to serious. Factors that can influence symptoms include:
General symptoms may include:
You will be asked about your symptoms and health history. A physical exam will be done. The doctor will listen to your heart for a murmur. Testing will include:
The first goal of treatment is to stop the infection. This will decrease the chance of lasting problems. Further treatment may be needed if the infection caused damage to the heart.
Antibiotics will help to fight the infection. The type will depend on what exact germ is causing the infection.
It may first be given through an IV at the hospital. The medicine may them be continued as pills at home. Treatment may last for up to 6 weeks.
Surgery may be needed to:
IE is not common. Some people may have a higher risk. If you have a risk of IE the following may help decrease chance of an infection:
American Heart Association
Mouth Healthy—American Dental Association
Canadian Dental Association
Heart and Stroke Foundation of Canada
Antibiotic prophylaxis prior to dental procedures. American Dental Association website. Available at: https://www.ada.org/en/member-center/oral-health-topics/antibiotic-prophylaxis. Updated August 5, 2019. Accessed January 7, 2019.
Infective endocarditis. American Heart Association website. Available at: https://www.heart.org/en/health-topics/infective-endocarditis. Accessed September 6, 2019.
Infective endocarditis. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated May 21, 2019. Accessed September 6, 2019.
Thanavaro KL, Nixon JV. Endocarditis 2014: an update. Heart Lung. 2014;43(4):334-337.
Last reviewed September 2019 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC