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Basic Facts

  • Endocarditis is an infection of the heart valves and the inner lining of the heart.
  • Typically, bacteria from another part of the body spread through the bloodstream and lodge in abnormal heart valves, causing endocarditis.
  • Occasionally other forms of infection, like yeasts, can cause endocarditis, or the cause may be related to another disease (such as lupus) and not infectious at all.
  • Antibiotic therapy is usually effective in clearing the infection.
The epicardium is the heart's outer layer. The endocardium is a thin membrane that lines the heart's four chambers, the four valves, and the muscles that connect with the valves. Endocarditis is an infection of this inner lining of the heart. Typically, bacteria from another part of the body spread through the bloodstream and lodge in abnormal heart valves or very rarely tissue, and cause endocarditis.

Endocarditis causes unhealthy inflammation. The condition is uncommon in people whose hearts are healthy; it occurs most commonly in people with heart disease or damaged valves. Alternatively, endocarditis can occur in the setting of a normal heart valve with intravenous drug abuse.

There are three types of endocarditis:
  • Native valve endocarditis;
  • Prosthetic valve endocarditis; and
  • Marantic endocarditis.

Some patients experience no symptoms. If symptoms are present, they may develop slowly or suddenly, and may include:
  • Fever and/or chills;
  • Excessive sweating;
  • Fatigue;
  • Shortness of breath;
  • Aches and pains in the joints or muscles;
  • Swelling of the feet, legs, or abdomen;
  • Abnormal color or blood in the urine; and
  • Osler's nodes or Janeway lesions.

The causes and risk factors of infectious endocarditis vary, and include:
  • Poor dental health;
  • Recent dental surgery;
  • Artificial heart valves;
  • Congenital heart disease;
  • Damaged heart valves or prior valve surgery; and
  • A history of endocarditis or heart disease.

The physician will take the patient's medical history and perform a physical examination and may order one or more of the following tests:
  • Blood test;
  • Blood culture;
  • X ray;
  • Echocardiogram;
  • Transesophageal echocardiogram (TEE); and
  • Electrocardiogram.

Infectious endocarditis is treated with antibiotics, first intravenously at the hospital and then with intravenous and/or oral antibiotics that the patient takes at home. The type of antibiotic used depends on the unique situation and determination of most likely infecting organisms. Patients remain in the hospital until the infection is under control; the full course of treatment is usually 6 weeks.

If the infection has damaged the heart valves or other organs or caused stroke, surgery may be necessary. The surgeon will remove any diseased tissue and heart valve surgery will be performed to repair or replace the damaged valve.
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