Endocarditis is inflammation of the heart valves or inner lining caused by germs from the mouth, gut, skin, or mushrooms. It carries serious health risks, but early treatment can lead to a positive prognosis. People with pre-existing heart conditions are most susceptible, and surgeries and dental procedures pose the greatest risk. Symptoms can be subacute or acute, and medical tests are used to detect the infection. Antibiotics and heart valve replacement surgery are treatments, and preventive antibiotics can be taken before risky procedures.
Endocarditis is inflammation of the heart valves or inner lining. The condition occurs when germs from the mouth, gut, or skin reach the bloodstream and infect regions of the heart. Mushrooms have also been recognized as a causal source of heart infection. While endocarditis is not common, it carries serious health risks.
Complications include congestive heart failure, blood clots, rapid or irregular heartbeats called arrhythmias, strokes, and nerve and brain damage. Early treatment of endocarditis can lead to a positive prognosis, but if left untreated, the infection can cause death.
People with pre-existing heart conditions are the most susceptible to developing endocarditis. The infection rarely occurs in people with healthy hearts. Surgeries and dental procedures that cause a significant amount of bleeding pose the greatest risk of endocarditis. Injection drug use and a history of rheumatic fever are some other risk factors in developing the infection.
Symptoms can be subacute, which means they develop slowly, or acute, which means they develop suddenly, and can include fever, chills, excessive sweating, bleeding under the fingernails, and blood in the urine. Other signs of endocarditis include fatigue, weight loss, red spots on the skin, and bloating or swelling of the feet and legs.
Medical tests may reveal an enlarged spleen, a new heart murmur or changes in an existing heart murmur, splinter hemorrhages under the nails, or clubbing (curving) of the nails. Repeated blood cultures are often considered the most reliable method of detecting endocarditis. Eye exams are also commonly done when endocarditis is suspected because the membrane of the eye called the conjunctiva may contain retinal hemorrhages known as Roth spots and/or small hemorrhages called petechiae.
Serology, which is a blood test used to detect antibodies made against a microorganism, may be done if the blood culture fails to detect the bacteria. Viral endocarditis is a subtype of endocarditis, but microorganisms such as bacteria and fungi are usually present in most cases of endocarditis, rather than a virus.
Once the bacteria are found, antibiotics selected to eliminate the specific organism can be given to the patient for up to 6 weeks. Antibiotics are usually started by intravenous injection in the hospital, with the patient continuing antibiotic therapy at home. If the endocarditis becomes more complex, such as when the infection breaks down and causes a series of strokes, or heart failure occurs, heart valve replacement surgery is often needed.
People at risk for endocarditis can take preventive antibiotics before doing any risky dental and medical work. Antibiotics can prevent the survival of bacteria that can enter the bloodstream during these procedures.
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