Endocarditis – Causes, Symptoms, Diagnosis, & Treatment
What is endocarditis?
Endocarditis is an infection of the endocardium. Endocardium is the smooth membrane that lines the insides of the heart chambers and surface of the heart valves
What causes endocarditis?
Endocarditis is usually caused by a bacterial infection, but sometimes a fungal infection can also cause it. It occurs when germs enter and multiply in the bloodstream and spread across the inner lining of the heart. Endocarditis can involve the heart muscle, heart valves, or lining of the heart. Sometimes, the cause is not found.
Germs may enter the bloodstream during:
- Central venous access lines
- Injections (drug use), from the use of unclean needles
- Dental surgery
- Surgeries or minor procedures to the breathing tract, urinary tract, infected skin, or bones and muscles
People with the following conditions may also develop endocarditis:
- Congenital heart defect
- Abnormal or damaged heart valve
- Past history of endocarditis
- New heart valve after surgery
- Intravenous drug use
What are the symptoms of endocarditis?
Symptoms of endocarditis may develop slowly or suddenly. Fever, chills, and sweating are the common symptoms that occur frequently. Fatigue, weakness, and aches and pains in the muscles or joints are the other symptoms. These sometimes can come and go, or be more noticeable during nighttime. They may present for days before any other symptoms appear.
The following are the other symptoms that may occur:
- Shortness of breath with activity
- Splinter hemorrhages (bleeding under the nails)
- Janeway lesions (painless red skin spots on the palms and soles)
- Osler nodes (painful red nodes in the pads of the fingers and toes)
- Swelling of feet, legs, abdomen
How is endocarditis diagnosed?
Your doctor will perform a physical exam and review your symptoms. The doctor will also examine your heart sounds with a stethoscope to look for a new heart murmur or a change in a past heart murmur.
An eye exam may show Roth spots, which are signs of bleeding in the retina and a central area of clearing. The exam may also find small, pinpoint areas of bleeding on the surface of the eye or the eyelids.
Your doctor may order the following tests to confirm the diagnosis:
- Blood culture to identify the bacteria or fungus that is causing the infection
- Complete blood count (CBC)
- C-reactive protein (CRP)
- Erythrocyte sedimentation rate (ESR)
- Echocardiogram to check the heart valves
How is endocarditis treated?
The doctor may recommend a hospital admission to give antibiotics intravenously (IV). Then, the doctor may recommend long-term antibiotics therapy for 4 to 6 weeks to completely eliminate the bacteria from the heart chambers and valves.
The doctor may recommend surgery to replace the heart valve if:
- The infection breaks into little pieces, leading to strokes.
- The heart valves are damaged leading to heart failure.
- There is evidence of more severe organ damage.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.