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
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]