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Endocarditis

Pronounced: En-doh-kar-dite-iss

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, which is 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 increase your risk of getting 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:

  • Your bodily fluids may be tested. This can be done with blood tests.
  • Your heart may be examined. This can be done with echocardiogram.
Treatment

Treatment may include:

  • Antibiotics—given through your veins 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 disease—heart defects
  • Artificial heart valves
  • History of endocarditis
  • Heart transplant recipients who have developed valve disease

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

RESOURCES:

American College of Cardiology
http://www.acc.org

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

CANADIAN RESOURCES:

Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca

University of Ottawa Heart Institute
http://www.ottawaheart.ca

References:

Braunwald E, Zipes DP, Libby P, et al. Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. Philadelphia, PA: WB Saunders Company; 2001.

Cecil RL, Goldman L, Bennett JC. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.

Conn HF, Rakel RE, Bope ET. 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 DynaMed's Systematic Literature Surveillance : Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis. Guidelines from the American Heart Association. Circulation. 2007 Apr 19. [Epub ahead of print]



Last reviewed December 2013 by Michael J. Fucci, DO

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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