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Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention


The endocardium is the inner lining of the heart muscle. Endocarditis is an infection of this lining and the heart valves.


Causes of endocarditis include:

  • Bacterial infection —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 may increase your risk of endocarditis include:


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


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:


Treatment may include:

  • Antibiotics—given by IV for up to 4-8 weeks
  • Surgery—to repair or replace the valve if it is severely damaged or has caused heart failure


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 defects
  • Artificial heart valves
  • History of endocarditis
  • Heart transplant recipients who have developed valve disease

Avoiding illicit IV drugs will also decrease your risk of infection.





  • 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, et al. 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: Updated March 20, 2013. Accessed March 20, 2013.
  • Infective endocarditis. EBSCO DynaMed website. Available at: Updated September 5, 2012. Accessed March 20, 2013.
  • DynaMed's Systematic Literature Surveillance Wilson W, Taubert KA, et al. Prevention of infective endocarditis. Guidelines from the American Heart Association. Circulation. 2007;116(15):1736-1754.

Last reviewed December 2014 by Michael J. Fucci, DO

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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