What is infective endocarditis?
Infective endocarditis is an infection of the thin layer of
tissue lining the inside of the heart muscle and valves
(endocardium).
The infection is caused by organisms (such as bacteria,
yeasts, and fungi) that attach themselves to the lining,
usually on the heart valves. They grow there, damaging the
valves.
How does it occur?
You are more at risk for endocarditis if you have:
- previous heart damage from having had rheumatic fever
- some types of heart problems present from birth
- an abnormal heart valve caused by aging or breakdown of
valve tissue
- had endocarditis before
- artificial heart valves.
The most common ways bacteria can enter the blood are:
- during dental procedures
- after an injury with an open wound
- from shared needles during drug use
- during certain surgical and diagnostic procedures.
Endocarditis may occur if you are hospitalized with IV
tubes, especially if you need the tubes for more than a day
or two.
What are the symptoms?
The most usual symptoms are:
- persistent fever
- sweats
- chills
- loss of appetite
- fatigue
- weight loss
- joint and muscle pains.
You may also have a heart murmur. The symptoms usually get
worse over a period of days or weeks. In early stages, the
infection may be mistaken for the flu.
How is it diagnosed?
Your doctor will take note of your symptoms and examine
you. He or she may order the following tests to confirm the
diagnosis:
- Echocardiography uses ultrasound pictures of your heart
structures to detect small areas of infection, called
vegetations, attached to the heart valves.
- A transesophageal echocardiogram (TEE) is a special echo
picture taken through a small tube passed down your
esophagus. This view gives the clearest pictures of the
vegetations.
- Blood samples will be tested for infection and to
identify the bacteria causing it. The vegetations on the
valves give off a shower of bacteria into the
bloodstream. However, if you have taken antibiotics
during the 2 weeks before the blood test, identification
of the bacteria may be delayed or impossible.
How is it treated?
You will take antibiotics for 4 to 6 weeks. You can usually
take the last weeks of antibiotic treatment at home.
You may need to have surgery right away if the antibiotics
are not able to get rid of the infection or if one of the
heart valves is severely damaged.
How long do the effects last?
Successful treatment of the infection may not be enough to
restore normal health if a heart valve has been damaged too
much. If the valve has been damaged too much, your heart
has to work harder and may become enlarged. You may not be
able to exercise as much as you used to. If this happens,
you may benefit from valve replacement surgery.
If you have an artificial heart valve and get endocarditis,
the infected valve must usually be replaced with a new one
to be sure of a cure. If treatment for endocarditis is not
successful, you run the risk of a stroke or damage to the
kidneys.
Can it be prevented?
Tell your health care provider or dentist if you are at risk
for endocarditis. If you are at risk for the disease, take
antibiotics before you have dental work or before tests to look
into your bladder or rectum. The use of antibiotics before
the procedures can prevent infection.


Disclaimer: This content is reviewed periodically and is subject to
change as new health information becomes available. The
information provided is intended to be informative and educational and is not a
replacement for professional medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
HIA File CRD3634F.HTM Release 9.0/2006. Copyright © 2006 McKesson Corporation and/or one of its subdiaries. All Rights Reserved.
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