Endocarditis is inflammation of your heart’s inner lining, called the endocardium. This condition is also called infective endocarditis. It’s usually caused by bacteria. Endocarditis is uncommon in people with healthy hearts.
The symptoms of endocarditis aren’t always severe, and they may develop slowly over time. In the early stages of endocarditis, the symptoms are similar to many other illnesses. This is why many cases go undiagnosed. Many of the symptoms are similar to cases of the flu or general infections, such as pneumonia. However, some people experience severe symptoms that appear suddenly. These symptoms may be due to inflammation or the damage it causes.
Common symptoms of endocarditis include:
- pale skin
- a fever
- night sweats
- muscle pain
- joint pain
- a decreased appetite
- a full feeling in the upper left part of your stomach
- weight loss
Severe signs and symptoms of endocarditis include:
- blood in your urine
- swollen feet
- swollen legs
- swollen stomach
- shortness of breath
- a cough
- weight loss
- an enlarged spleen, which may be tender to touch
- a heart murmur, which is an unusual sounding heartbeat
Changes in the skin may also occur, including:
- red or purple spots on or under the fingers or toes
- broken blood vessels that appear as red spots and are usually on the whites of the eyes, inside of the cheeks, on the roof of the mouth, or on the chest
The signs and symptoms of endocarditis vary greatly from person-to-person. They can change over time, and they depend on the cause of your infection. If you have a history of heart problems, heart surgery, or endocarditis, you should contact your doctor immediately if you have any of these symptoms, especially if you have a fever that has lasted longer than three days or you’re unusually tired and don’t know why.
The main cause of endocarditis is an overgrowth of bacteria. Although these bacteria normally live on the outside of your body, you might bring them inside by eating or drinking, or through cuts in your skin. Your immune system normally fights off germs before they cause a problem. However, this process fails in some people.
In the case of endocarditis, the germs travel through your bloodstream and into your heart, where they multiply and cause inflammation. Endocarditis can also be caused by fungi or other germs, and in some cases, there’s no known cause.
Eating and drinking aren’t the only ways that germs can enter your body. They can also get into your bloodstream through:
- brushing your teeth
- having poor oral hygiene or gum disease
- contracting a sexually transmitted disease
- using a contaminated needle
- wearing a catheter
- having a dental procedure that cuts your gums
The following are risk factors for developing endocarditis:
- Injecting illicit drugs with a needle contaminated with bacteria or fungi can cause endocarditis. The germs pass into your bloodstream and then travel to your heart.
- Scarring caused by heart valve damage is a perfect place for bacteria or other germs to grow.
- If you’ve had endocarditis before, you’re at risk of having it again because of tissue damage.
- Having a heart defect increases your risk of developing endocarditis.
- You’re at the highest risk of getting endocarditis during the first year after receiving an artificial heart valve.
Your doctor will go over your symptoms and medical history before conducting any tests. After this review, they’ll use a stethoscope to listen to your heart. The following tests may also be done:
If your doctor suspects you have endocarditis, a blood test will be ordered to confirm whether bacteria, fungi, or other microorganisms are causing it. A blood test can also reveal if your symptoms are caused by another condition, such as anemia.
An echocardiogram is an imaging test used to view your heart and its valves. This test uses ultrasound waves to create an image of your heart. Your doctor can use this imaging test to look for signs of damage or sluggish movements in your heart.
When an echocardiogram doesn’t provide enough information to assess your heart accurately, your doctor might order an additional imaging test called a transesophageal echocardiogram. This is used to view your heart by way of your throat. Your doctor will insert a thin probe down your throat to get a more detailed view of your heart. Your doctor or a lab technician will spray numbing medication on the back of your throat to minimize discomfort.
An electrocardiogram may be requested to get a better view of your heart. This test can also detect an abnormal heart rhythm.
A collapsed lung can cause many of the same symptoms as endocarditis. A chest X-ray may be used to view your lungs and to see if they’ve collapsed or if fluid has built up in them, which is called pulmonary edema. This can help your doctor tell the difference between endocarditis and a collapsed lung.
If your endocarditis is caused by bacteria, it will be treated by antibiotics. Your doctor will advise you to take these drugs until your infection and inflammation are gone. This normally takes six weeks. If your infection is advanced, you may receive these antibiotics intravenously, or through an IV, in a hospital until you show signs of improvement.
Damaged heart valves caused by endocarditis may require surgery to correct. Surgery can be done to remove your damaged heart valves and replace them with artificial valves. If you have a milder case, the damaged area of your valve may be removed and replaced with man-made material or animal tissue.
Complications may develop from damage caused by your infection. These can include an abnormal heart rhythm such as atrial fibrillation, blood clots, and jaundice. This damage may not be confined to your heart, where endocarditis can result in damaged heart valves. Infected blood can also cause emboli, or clots, to travel to other parts of your body.
Other organs that can be affected include the following:
- In your kidneys, tiny vessels, or glomeruli, may become inflamed. This is called glomerulonephritis.
- Clots may travel to your lungs.
- Clots may travel to your brain and damage it.
- Your bones, particularly your spinal column, can become infected. This is called osteomyelitis.
Bacteria can escape from your heart and affect these areas. Bacteria can also cause abscesses to develop in your organs or other parts of your body.
Some severe complications that can arise from endocarditis include stroke and heart failure.
Having good oral hygiene and keeping regular dental appointments can eliminate some of the harmful bacteria that can build up in your mouth. This reduces your risk of developing endocarditis from swallowing these bacteria. If you’ve undergone a dental treatment that was followed up with antibiotics, make sure to take your antibiotics as directed.
If you have a history of heart disease, heart surgery, or endocarditis, be on the watch for the signs and symptoms of endocarditis. Pay special attention to a persistent fever and unexplained fatigue. Contact your doctor as soon as possible if you have any of these symptoms. You should also avoid:
- body piercings
- IV drug use
- any procedure that might allow germs to enter your blood