Endocarditis (inflammation of the heart valve)

Endocarditis

Cardiovascular,Dental,Emergency Medicine

Written by the doctors and editors at UpToDate
What is endocarditis? — Endocarditis is the term doctors use when a heart valve (or valves) gets inflamed or infected (figure 1).
Endocarditis can lead to serious problems, such as:
Heart damage and heart problems – Damage of the heart valves can lead to a condition called "heart failure." Heart failure is when the heart has trouble pumping blood around the body.
Small growths that form on the heart valves – Pieces of these growths can break off and travel through the blood to different parts of the body. They can then get stuck in and block off small blood vessels. This can cause organ damage and symptoms.
What causes endocarditis? — Endocarditis is usually caused by bacteria. It can happen when:
People have an infection in another part of the body. The bacteria from that infection can travel through the blood to the heart.
Bacteria enter the body through the skin or mouth, and then travel through the blood to the heart. This can happen during dental surgery, or if people have a catheter (a thin tube that goes into a vein) for a long time. It can also happen if people inject drugs into their vein.
Many people who get endocarditis already have a heart problem or have had heart valve surgery in the past.
What are the symptoms of endocarditis? — Endocarditis usually causes a fever and chills.
If the endocarditis has caused problems with the heart or other organs, people can have other symptoms, too. For example, people who have heart failure can have trouble breathing, and swelling in their feet or legs. People who have kidney damage (from pieces of a growth that have broken off and traveled to the kidneys) can have red or brown urine.
If pieces of a growth travel to and block blood vessels in the brain, it can cause a stroke. A stroke is when a part of the brain is damaged because of a problem with blood flow. Symptoms of a stroke can include trouble speaking, or weakness or numbness in one or both arms.
Should I see a doctor or nurse? — Yes. See your doctor or nurse if you have a fever that lasts for many days, especially if you have a heart condition. You should also tell your doctor or nurse if you have any of the other symptoms mentioned above.
Will I need tests? — Yes. Your doctor or nurse will ask about your symptoms and do an exam. During the exam, he or she will listen for a heart murmur, which is an extra sound in your heartbeat. A heart murmur is sometimes a sign of endocarditis.
Your doctor or nurse will also probably do:
Blood tests, including a test called a "blood culture"
A chest X-ray
An ECG (also called an "electrocardiogram") – This test measures the electrical activity in your heart (figure 2).
An echocardiogram (also called an "echo") – This test uses sound waves to create a picture of your heart as it beats (figure 3).
How is endocarditis treated? — Endocarditis is usually treated in the hospital with antibiotic medicines. These medicines go into your vein through a tube called an "IV."
In most cases, the antibiotic medicines get rid of the infection. But if they don't, or if your endocarditis has caused serious heart valve problems, you might need surgery. Surgery for endocarditis usually involves replacing your diseased heart valve with a heart valve that works normally.
How can I prevent getting endocarditis again? — Some people need to take antibiotics before they go to the dentist or have certain procedures. This can help prevent getting endocarditis again. Ask your doctor or nurse if you need to take antibiotics before those times.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 17037 Version 7.0
Release: 28.2.2 - C28.105
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Acute Bacterial Endocarditis,Acute Endocarditis,Heart Valve Infections,IE,Infective Endocarditis,SBE,Subacute Bacterial Endocarditis

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© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.