What is endocarditis?

You may feel like you have the flu. Symptoms may include a fever, chills, and feeling tired. Other symptoms include weight loss, headache, night sweats, and painful joints.

If you are at risk for endocarditis or the symptoms do not go away, call your doctor.

Treatment may include:

• Antibiotics or antifungal medicine given through a small tube placed in a vein (I.V.). You may need several weeks of treatment. You might also take antibiotic pills.
• Surgery to repair or replace heart valves.

You may have follow-up visits for months or years to check the health of your heart.

• Practice good oral hygiene by brushing and flossing your teeth daily. See a dentist twice each year. Tell your dentist that you are at risk for this infection.
• You may need to take antibiotics before some dental and medical procedures if you:
  • Have had a heart valve replaced or repaired.
  • Have had endocarditis before.
  • Have had certain heart problems since birth.
  • Have heart valve problems after a heart transplant.

Ask your doctor or dentist if you need antibiotics to prevent this infection. Find out when you will need to take them.

Your doctor may give you a card that says you may need preventive antibiotics before some procedures. You can keep it in your wallet.

First, your doctor will ask about your medical history and your symptoms. The doctor will also do a physical exam to check for signs of the infection. These signs include a heart murmur, an enlarged spleen, and bleeding under the nails.

Your doctor may also do tests, such as:

• Blood cultures. These tests look for bacteria in your bloodstream.
• Echocardiogram. This is done to check your heart for problems such as infected areas or heart valve defects.
• Electrocardiogram (EKG or ECG). This test checks for heart rhythm problems.
• A chest X-ray. This is to see if your heart is enlarged or if you have signs of heart failure.
• An MRI (magnetic resonance imaging) test or a CT scan. These may be done as additional tests to check your heart for problems.

Take all medicines as instructed. If antibiotics were prescribed, take them until they are gone. Tell your doctor and dentist that you've had endocarditis. You may need to take antibiotics before certain procedures. Practice good oral hygiene. Brush and floss your teeth daily.

Your risk is higher if you have a problem that affects blood flow through your heart. That's because a blood flow problem makes it more likely that bacteria or fungi will attach to heart tissue. Some other things raise your risk too, because they can let bacteria or fungi enter your bloodstream.

You have a higher risk of endocarditis if you:

• Have had endocarditis in the past.
• Have an implanted heart device such as a pacemaker or implantable cardioverter-defibrillator (ICD).
• Have a hemodialysis access or a central vascular access device.
• Have abnormal or damaged heart valves.
• Have had a heart valve replaced or repaired.
• Have a congenital heart defect.
• Have injected drugs.

Not all heart problems put you at higher risk for endocarditis. You do not have a higher risk if you have had:

• Bypass surgery for heart disease.
• Rheumatic fever without heart valve damage.
• A heart attack without other complications.
• Mitral valve prolapse without regurgitation or unusually thickened valve leaflets.
• A coronary artery stent.

Endocarditis (say "en-doh-kar-DY-tus") is an infection of the heart's valves or inner lining of the heart. It is most often caused by bacteria. It also can be caused by fungi. The bacteria or fungi get into the bloodstream. They settle and grow on the inside of the heart, usually on the heart valves. Bacteria or fungi can enter the bloodstream in many ways, such as injecting drugs and having some dental and medical procedures.

This infection can damage your heart. You need to treat it as soon as possible.

People who have a normal heart are not likely to get endocarditis. But some people are more likely to get it than others. This includes people who have a heart problem that affects normal blood flow, such as a heart valve problem, or people who inject illegal drugs.

Endocarditis can be very serious. It may be more dangerous for people who:

• Have had a heart valve replaced or repaired.
• Have had this kind of infection before.
• Have had certain heart problems since birth.
• Have heart valve problems after a heart transplant.