Endocarditis is an infection that affects the inner lining of the heart valves and, in some cases, the inner lining of the heart chambers. This condition typically occurs when bacteria enter the bloodstream, though it may also result from fungal or other microbial infections. Read on to learn more about the key aspects of endocarditis.

Causes of Endocarditis

Endocarditis is a rare condition, usually caused by a bacterial infection that enters the bloodstream through various means, such as dental procedures (especially tooth extractions) or endoscopic examinations. In some cases, bacteria may enter the bloodstream from the mouth, skin, intestines, respiratory system, or urinary system during activities like eating, brushing teeth, or defecating.

Below are some medical conditions that increase the risk of developing endocarditis:

• Diseases like rheumatic fever or infections that damage one or more heart valves, increasing susceptibility to infection
• A weakened immune system
• Heart valve replacement with an artificial valve
• Congenital heart defects
• Pacemaker implantation
• Hypertrophic cardiomyopathy
• Poor oral hygiene
• Long-term use of a heart catheter

Symptoms of Endocarditis

The symptoms of endocarditis vary from person to person and may develop gradually or suddenly. They also depend on the type of microorganism causing the infection and the presence of other heart problems. Below are some common symptoms:

• Fatigue
• Chest pain when breathing
• Shortness of breath
• Swelling in the legs, feet, or abdomen
• A new or changing heart murmur
• Night sweats
• Flu-like symptoms, such as fever and chills
• Joint and muscle pain

Less Common Symptoms

• Blood in the urine
• Unexplained weight loss
• Painless flat spots that are red, purple, or brown on the soles of the feet or palms of the hands
• Painful red or purple nodules or dark spots on the fingertips or toes
• Small red, purple, or brown circular spots in the whites of the eyes, mouth, or other areas

Diagnosis of Endocarditis

The doctor may order several tests to diagnose endocarditis, including:

• Complete blood count (CBC): Helps detect an elevated white blood cell count, which can indicate an infection.
• Blood tests: For example, C-reactive protein (CRP) tests can identify inflammation in the body.
• Blood culture: Determines the type of bacteria or microorganism in the bloodstream and helps guide the choice of antibiotics.
• Echocardiogram: Uses ultrasound to produce images of the heart, showing how well the chambers and valves are pumping blood. It can also reveal structural abnormalities in the heart.
• Positron emission tomography (PET) scan: Uses a radioactive substance to help locate the infection in the heart.

Treatment of Endocarditis

Treatment for endocarditis may include the following:

1) Antibiotics

• If the infection is caused by bacteria, intravenous (IV) antibiotics are used.
• The doctor will recommend continuing antibiotic therapy until the infection and inflammation are fully treated.
• This treatment usually begins in the hospital for at least one week to monitor improvement. After discharge, oral antibiotics may be prescribed for continued treatment.
• Antibiotic therapy typically lasts up to six weeks.

2) Surgery

• In severe or complicated cases, surgery may be necessary to replace damaged valves or remove infected tissue.

Conclusion

Endocarditis is a rare but serious condition that requires prompt treatment to prevent complications such as heart failure, kidney failure, or pulmonary embolism.