Infective Endocarditis

What is infective endocarditis?

Infective endocarditis is an infection of the thin layer of tissue lining the inside of the heart muscle and valves (endocardium).

The infection is caused by organisms (such as bacteria, yeasts, and fungi) that attach themselves to the lining, usually on the heart valves. They grow there, damaging the valves.

How does it occur?

You are more at risk for endocarditis if you have:

previous heart damage from having had rheumatic fever
some types of heart problems present from birth
an abnormal heart valve caused by aging or breakdown of valve tissue
had endocarditis before
artificial heart valves.

The most common ways bacteria can enter the blood are:

during dental procedures
after an injury with an open wound
from shared needles during drug use
during certain surgical and diagnostic procedures.

Endocarditis may occur if you are hospitalized with IV tubes, especially if you need the tubes for more than a day or two.

What are the symptoms?

The most usual symptoms are:

persistent fever
sweats
chills
loss of appetite
fatigue
weight loss
joint and muscle pains.

You may also have a heart murmur. The symptoms usually get worse over a period of days or weeks. In early stages, the infection may be mistaken for the flu.

How is it diagnosed?

Your doctor will take note of your symptoms and examine you. He or she may order the following tests to confirm the diagnosis:

Echocardiography uses ultrasound pictures of your heart structures to detect small areas of infection, called vegetations, attached to the heart valves.
A transesophageal echocardiogram (TEE) is a special echo picture taken through a small tube passed down your esophagus. This view gives the clearest pictures of the vegetations.
Blood samples will be tested for infection and to identify the bacteria causing it. The vegetations on the valves give off a shower of bacteria into the bloodstream. However, if you have taken antibiotics during the 2 weeks before the blood test, identification of the bacteria may be delayed or impossible.

How is it treated?

You will take antibiotics for 4 to 6 weeks. You can usually take the last weeks of antibiotic treatment at home.

You may need to have surgery right away if the antibiotics are not able to get rid of the infection or if one of the heart valves is severely damaged.

How long do the effects last?

Successful treatment of the infection may not be enough to restore normal health if a heart valve has been damaged too much. If the valve has been damaged too much, your heart has to work harder and may become enlarged. You may not be able to exercise as much as you used to. If this happens, you may benefit from valve replacement surgery.

If you have an artificial heart valve and get endocarditis, the infected valve must usually be replaced with a new one to be sure of a cure. If treatment for endocarditis is not successful, you run the risk of a stroke or damage to the kidneys.

Can it be prevented?

Tell your health care provider or dentist if you are at risk for endocarditis. If you are at risk for the disease, take antibiotics before you have dental work or before tests to look into your bladder or rectum. The use of antibiotics before the procedures can prevent infection.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File CRD3634F.HTM Release 9.0/2006