Endocarditis is inflammation of the inside lining of the heart chambers and heart valves (endocardium).
Endocarditis can involve the heart muscle, heart valves, or lining of the heart. Most people who develop endocarditis have have some abnormality of a heart valve.
Risk factors for developing endocarditis include:
Bacterial infection is the most common source of endocarditis. However, it can also be caused by fungi. In some cases, no cause can be identified.
Note: Endocarditis symptoms can develop slowly (subacute) or suddenly (acute).
Doctors might suspect endocarditis in people with a history of:
An eye exam may show bleeding in the retina a central area of clearing. This is known as Roth's spots. There may be small, pinpoint hemorrhages (petechiae) in the conjunctiva. The fingertips may be enlarged, and the nails may appear curved. This is called clubbing.
People with this condition will often need to be hospitalized at first to receive antibiotics through a vein (intravenously). Long-term antibiotic therapy is needed to get the bacteria out of the heart chambers and valves.
Patients will usually have therapy for 4-6 weeks. The antibiotic must be specific for the organism causing the condition. This is determined by the blood culture and the sensitivity tests.
Surgery to replace the heart valve is usually needed when:
Early treatment of endocarditis improves the chances of a good outcome. However, valve destruction or strokes can result in death.
Call your health care provider if you notice the following symptoms during or after treatment:
The American Heart Association recommends preventive antibiotics for people at risk for infectious endocarditis before:
Antibiotics are more likely to be recommended those with the following risk factors:
Continued medical follow-up is recommended for people with a previous history of infectious endocarditis.
Persons who use intravenous drugs should seek treatment for addiction. If this is not possible, use a new needle for each injection, avoid sharing any injection-related paraphernalia, and use alcohol pads before injecting to reduce risk.
Fowler VG Jr, Scheld WM, Bayer AS. Endocarditis and Intravascular Infections. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009; chapt 77.
Karchmer AW. Infective Endocarditis. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007:chap 63.
Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective 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. 2007 Oct 9;116(15):1736-54.