Definition
Definition
The endocardium is the inner lining of the heart muscle. Endocarditis is an infection of this lining and the heart valves.
Causes
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 EndocarditisCopyright © Nucleus Medical Media, Inc.
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Risk Factors
Risk Factors
Factors that may increase your risk of endocarditis include:
- Having an artificial heart valve
- History of endocarditis
- History of rheumatic fever, which can damage heart valves
- Heart defects
- Enlarged heart
- Mitral valve prolapse
- History of IV drug use
-
Recent procedures that can lead to
bacterial endocarditis, including:
- Tooth cleaning
- Tonsillectomy and adenoidectomy
- Bronchoscopy
- Surgery on the gastrointestinal, urinary, or respiratory tracts
- Gallbladder or prostate surgery
Symptoms
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
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:
- Blood tests
- Echocardiogram
Treatment
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
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:
Mouth Healthy—American Dental Association http://www.mouthhealthy.org
CANADIAN RESOURCES:
Heart and Stroke Foundation of Canada http://www.heartandstroke.com
References:
Cecil RL, Goldman L, Bennett JC. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
Conn HF, Rakel RE, et al. Conn’s Current Therapy 2001: latest approved methods of treatment for the practicing physician. 53rd ed. Philadelphia, PA: WB Saunders Company; 2001.
Infective endocarditis. American Heart Association website. Available at:
http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Infective-Endocarditis_UCM_307108_Article.jsp
Updated March 20, 2013. Accessed March 20, 2013.
Infective endocarditis. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated September 5, 2012. Accessed March 20, 2013.
DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Wilson W, Taubert KA, et al. Prevention of infective endocarditis. Guidelines from the American Heart Association. Circulation. 2007;116(15):1736-1754.
Last Updated: 12/20/2014