Endocarditis

Endocarditis is the inflammation of the heart’s inner lining (endocardium), chambers, and valves caused by an infection. It occurs when germs—usually bacterial but in rare cases a fungal infection—in the bloodstream attach to the inner heart lining, valves, or blood vessels. Sometimes referred to as infective endocarditis or bacterial endocarditis, this heart infection is a serious condition, but getting treatment early greatly enhances outcomes.

Everyone experiences endocarditis symptoms differently. For some people, warning signs appear within a few days of infection and may look like flu symptoms, such as fever or chills. For others, symptoms may develop more slowly. Talk to your doctor if you have any of the following symptoms:

• Aching joints and muscles
• Anemia (low red blood cell count)
• Chills
• Cough that won’t go away
• Fatigue
• Fever
• Increased heart rate
• Night sweats
• Red spots on your skin, under your fingernails, the whites of your eyes, or inside your mouth
• Skin changes like red or purple bumps on your fingers or toes
• Swelling in your feet, legs, or abdomen
• Weight loss or loss of appetite

The most common cause of endocarditis is a bacterial infection that enters the bloodstream. It’s normal to have bacteria in the body—bacteria lives in the digestive tract, mouth, skin, and respiratory system. Sometimes, a normal activity like a break in the skin, brushing and flossing your teeth, dental work, or even having a bowel movement can allow bacteria to get into the bloodstream. While heart valves are resistant to infection, sometimes bacteria can attach to the inner heart lining, valves, or blood vessels and cause bacterial endocarditis in people who have damaged heart valves or tissue. This infection causes an inflammation of the inner lining of the heart and its surrounding structures.

People with a higher risk for endocarditis include those with a history of the following:

• Artificial heart valves
• Catheter use, such as for hemodialysis for kidney failure
• Congenital heart defect (present at birth)
• Heart transplant that resulted in a leaky valve
• Heart valve disease (a leaking or narrowed heart valve)
• Implantable cardiac devices such as a pacemaker or implantable cardioverter-defibrillator
• IV drug use
• Poor dental hygiene
• Previous endocarditis diagnosis
• Previous valve repair or replacement
• Rheumatic heart disease caused by strep throat or scarlet fever
• Weak immune system

In addition, adults over the age of 60 and people assigned male at birth have a higher risk for being diagnosed with endocarditis.

Not all cases of endocarditis can be prevented, but there are steps you can take to lower your risk of getting it. For example, practice good oral hygiene by brushing and flossing your teeth daily and visiting your dentist every six months, never use IV drugs, and seek medical care immediately if you show symptoms of endocarditis.

Your doctor may prescribe antibiotics for you to take before certain procedures, like dental work, or procedures that involve your digestive, respiratory, or urinary systems, as well as for treating skin infections.