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Endocarditis is an infection of the heart's valves or inner lining. It occurs when germs get into the bloodstream and settle inside the heart, often on a valve. The infection is usually caused by bacteria. In rare cases, it is caused by fungi.
This infection can damage your heart. It needs to be treated right away. If it isn't treated,
endocarditis can be deadly.
Your risk is higher if you have a problem that affects blood flow through your heart. That's because a blood flow problem makes it more
likely that bacteria or fungi will attach to heart tissue. Some other things raise your risk too, because they can let bacteria or fungi enter your bloodstream.
You have a higher risk of endocarditis if you have:
Not all heart problems put you at higher risk for endocarditis. You do not have a higher risk
if you have had:
Symptoms may appear quickly, within a few days of infection. In other cases, they may develop more slowly. The symptoms will get worse as the bacteria or fungi grow in your heart.
Symptoms may include:
See your doctor if you have symptoms like these that don't go away, especially if you are at risk for endocarditis.
If endocarditis isn't
treated soon, it can lead to more serious problems, such as:
First, your doctor
will ask about your medical history and your symptoms. The doctor will also do a physical exam to check for signs of the
infection. These signs include a
heart murmur, an enlarged spleen, and
bleeding under the nails.
Your doctor may also do tests, such as:
Endocarditis is usually treated with antibiotics. You will probably need several weeks of treatment. The antibiotics must be given long enough and at a strong enough dose to destroy all of the bacteria.
At first you will be treated in the hospital. This is so that antibiotics can be given through a vein (IV). After your fever is gone and you are stable, you may be able to continue IV antibiotics at home. A home health nurse can help you with this.
After you have been treated with IV antibiotics, your doctor may want you to take antibiotic pills. If so, take them exactly as prescribed until they are gone. If your symptoms come back, call your doctor right away. You probably will need more antibiotics if testing shows that the bacteria were not completely destroyed.
Some people who have endocarditis need surgery to repair or replace a heart valve or to prevent complications.
Endocarditis is most
dangerous for people who have:
If you have any of these heart problems, you may need
to take antibiotics before you have some kinds of dental work, surgery, or medical procedures. The
antibiotics lower your risk of getting endocarditis. Your doctor can give you
a wallet card to carry that says you need preventive
It's also very important to take good care of your teeth and gums every day. Good oral care can limit the growth of mouth bacteria that could get into your bloodstream.
Health Tools help you make wise health decisions or take action to improve your health.
Learning about endocarditis:
Living with endocarditis:
Visit the American Heart Association (AHA) website for information on
physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your
nearest local or state AHA group. The AHA provides brochures and information
about support groups and community programs, including Mended Hearts, a
nationwide organization whose members visit people with heart problems and
provide information and support.
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
Other Works Consulted
Baddour LM, et al. (2005). Infective endocarditis:
Diagnosis, antimicrobial therapy, and management of complications: A statement
for healthcare professionals from the Committee on Rheumatic Fever,
Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the
Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular
Surgery and Anesthesia, American Heart Association: Endorsed by the Infectious
Diseases Society of America. Circulation, 111(4):
Bonow RO, et al. (2008). 2008 Focused update
incorporated into the ACC/AHA 2006 Guidelines for the management of patients
with valvular heart disease: A report of the American College of
Cardiology/American Heart Association Task Force on Practice Guidelines
(Writing committee to revise the 1998 Guidelines for the management of patients
with valvular heart disease). Circulation, 118(15):
Endocarditis prophylaxis for dental procedures (2012). Medical Letter on Drugs and Therapeutics, 54(1339): 74. [Erratum in Medical Letter on Drugs and Therapeutics, 54(1401): 84].
Haldar SM, O'Gara PT (2011). Infective endocarditis. In V Fuster et al., eds., Hurst's the Heart, 13th ed., vol. 2, pp. 1940–1969. New York: McGraw-Hill.
Karchmer AW, Bonow RO (2012). Infective endocarditis. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 2, pp. 1540–1558. Philadelphia: Saunders.
Li JS, et al. (2007). Infective endocarditis. In EJ
Topol et al., eds., Textbook of Cardiovascular Medicine,
8th ed., pp. 402–419. Philadelphia: Lippincott Williams and
Wilson W, et al. (2007). Prevention of endocarditis.
Guidelines from the American Heart Association. A guideline from the American
Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease
Committee, Council on Cardiovascular Disease in the Young, and the Council on
Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the
Quality of Care and Outcomes Research Interdisciplinary Working Group.
Circulation. Published online April 19, 2007
July 26, 2013
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology & Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
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