• Endocarditis

    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%5FUCM%5F307108%5FArticle.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]

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