Home > Your Health > Medical Procedures > Aortic valve replacement > Endocarditis

Endocarditis by Rosalyn Carson-DeWitt, MD

Definition

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

Causes

Causes include:

Bacterial infection (most common cause)
Viral or fungal infection
Medical conditions that result in blood clotting too easily (causes a noninfectious form)

Bacterial Endocarditis

Risk Factors

Factors that increase your chance of endocarditis include:

Having an artificial heart valve
History of endocarditis
History of rheumatic fever , which can damage heart valves
Heart defects
Enlarged heart
Mitral valve prolapse
History of IV drug use
Recent procedures that can lead to bacterial endocarditis , including:
- Tooth cleaning
- Tonsillectomy and adenoidectomy
- Bronchoscopy
- Surgery on the gastrointestinal, urinary, or respiratory tracts
- Gallbladder or prostate surgery

Symptoms

Symptoms 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:

Blood tests—to check for infection
Echocardiogram —uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart

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 Heart Association http://www.americanheart.org/
Heart Information Network http://www.heartinfo.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.
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]

Last reviewed July 2010 by Michael J. Fucci, DO

All EBSCO Publishing proprietary, consumer health and medical information found on this site is accredited by URAC. URAC's Health Web Site Accreditation Program requires compliance with 53 rigorous standards of quality and accountability, verified by independent audits. To send comments or feedback to our Editorial Team regarding the content please email us at HLEditorialTeam@ebscohost.com.

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.