Endocarditis is an infection in the endocardium, the smooth inner lining of the heart that forms the surface of the valves. This condition is typically caused by bacteria entering the bloodstream, attaching to the heart valves and producing toxins and enzymes that break down tissues and create holes in the valves. The bacteria can enter the bloodstream through activities as simple as eating and brushing your teeth, or through wounds, sores and conditions such as gum disease.
Causes of Endocarditis
While anyone can get endocarditis, people with healthy hearts are rarely diagnosed with this condition. Those with preexisting heart defects—particularly those with damaged heart valves—make up the large majority of cases.
You may be more at risk for endocarditis if you have:
- Acquired valve disease
- A congenital heart defect
- A pacemaker or other medical device
- A condition that makes you immunocompromised
- Hypertrophic cardiomyopathy (HCM)
- Previously been diagnosed with bacterial endocarditis
Symptoms of Endocarditis
The early symptoms of endocarditis can mimic those of a seasonal cold or allergies, which means many cases go undiagnosed. Fever, chills, a sore throat, nasal congestion, headaches, sinus pressure, white patches in the mouth and a persistent cough are all common symptoms of endocarditis.
However, symptoms that differentiate themselves from a cold include:
- Changed or new heart murmurs
- Red or draining sores
- Swelling of the abdomen, legs or feet
- Wounds that are unable to heal
- Skin rash
Individuals with a history of heart problems should be especially watchful for symptoms of this condition. It is important to promptly seek medical attention if symptoms occur, as life-threatening complications can develop if left untreated.
Diagnosis of Endocarditis
Endocarditis is diagnosed based on a physical exam, during which your physician will review your symptoms and medical history. Then, he or she may order a blood culture to determine if bacteria, fungi or microorganisms common to endocarditis are present. For further confirmation, an echocardiogram may be ordered to get a full view of your heart and its valves.
Treatment for Endocarditis
Treatment for endocarditis most often involves several rounds of intravenous (IV) antibiotics. Patients typically stay in the hospital for the first phase of treatment or until severe symptoms have subsided.
If the infection does not respond to antibiotics, surgery may be recommended to address the infected area or replace a compromised heart valve. In cases of fungal infections, surgery may be used as an initial treatment.