Endocarditis

Definition

Causes

• Bacterial infection, which is the most common cause
• Viral or fungal infection
• Medical conditions that result in blood clotting too easily, causing a noninfectious form

Bacterial Endocarditis

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Risk Factors

• Having an artificial heart valve
• History of endocarditis
• History of rheumatic fever, which can damage heart valves
• Heart defects
• Enlarged heart
• Mitral valve prolapse
• History of IV drug use
• Recent procedures that can lead to bacterial endocarditis, including:
  • Tooth cleaning
  • Tonsillectomy and adenoidectomy
  • Bronchoscopy
  • Surgery on the gastrointestinal, urinary, or respiratory tracts
  • Gallbladder or prostate surgery

Symptoms

• Fever, chills
• Weakness, low energy
• Sweatiness, especially at night
• Shortness of breath
• Cough
• Loss of appetite, weight loss
• Chest pain
• Abdominal pain
• Nausea and vomiting
• Painful red bumps on the fingers and toes
• Purple dots on the whites of the eyes, under the fingernails, and over the collarbone
• Painful red patches on the fingers, palms, and soles

Diagnosis

• Your bodily fluids may be tested. This can be done with blood tests.
• Your heart may be examined. This can be done with echocardiogram.

Treatment

• Antibiotics—given through your veins for up to 4-8 weeks
• Surgery—to repair or replace the valve if it is severely damaged or has caused heart failure

Prevention

• You may need to take antibiotics before certain dental or medical procedures.
• Talk to your dentist or doctor before the procedure.

• Various forms of congenital heart disease—heart defects
• Artificial heart valves
• History of endocarditis
• Heart transplant recipients who have developed valve disease

RESOURCES

American College of Cardiology http://www.acc.org

American Heart Association http://www.heart.org

CANADIAN RESOURCES

Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca

University of Ottawa Heart Institute http://www.ottawaheart.ca

References

Braunwald E, Zipes DP, Libby P, et al. Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. Philadelphia, PA: WB Saunders Company; 2001.

Cecil RL, Goldman L, Bennett JC. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.

Conn HF, Rakel RE, Bope ET. Conn's Current Therapy 2001: latest approved methods of treatment for the practicing physician. 53rd ed. Philadelphia, PA: WB Saunders Company; 2001.

Infective endocarditis. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Infective-Endocarditis%5FUCM%5F307108%5FArticle.jsp . Updated March 20, 2013. Accessed March 20, 2013.

Infective endocarditis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 5, 2012. Accessed March 20, 2013.

DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis. Guidelines from the American Heart Association. Circulation. 2007 Apr 19. [Epub ahead of print]

Revision Information

• Reviewer: Michael J. Fucci, DO
• Review Date: 09/2012 -
• Update Date: 03/20/2013 -