Carl R. Darnall Army Medical Center - Health Library

Endocarditis

Definition

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

Causes ^

Causes of endocarditis include:

  • Bacterial infection —the most common cause
  • Viral or fungal infection
  • Medical conditions that result in blood clotting too easily, causing a noninfectious form

Bacterial Endocarditis
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Risk Factors ^

Factors that may increase your chances of endocarditis include:

Symptoms ^

Symptoms of endocarditis 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:

Treatment ^

Treatment may include:

  • Antibiotics—given by IV for up to 4-8 weeks
  • Surgery—to repair or replace the valve if it is severely damaged or has caused heart failure

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 defects
  • Artificial heart valves
  • History of endocarditis
  • Heart transplant recipients who have developed valve disease

Avoiding illicit IV drugs will also decrease your risk of infection.

RESOURCES:

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

Mouth Healthy—American Dental Association
http://www.mouthhealthy.org

CANADIAN RESOURCES:

Canadian Dental Association
http://www.cda-adc.ca

Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca

REFERENCES:

Infective endocarditis. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Infective-Endocarditis_UCM_307108_Article.jsp#.Wh8q3lWnHIU. Updated September 29, 2017. Accessed November 29, 2017.

Infective endocarditis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113919/Infective-endocarditis. Updated November 22, 2017. Accessed November 29, 2017.

12/17/2015 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T113919/Infective-endocarditis: Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis. Guidelines from the American Heart Association. Circulation. 2007;116(15):1736-1754.

Last reviewed November 2017 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC  Last Updated: 12/20/2014