Endocarditis
DEFINITION
Endocarditis is an infection of the inner lining of your heart (endocardium).
Endocarditis generally occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in your heart. Left untreated, endocarditis can damage or destroy your heart valves and can lead to life-threatening complications. Treatments for endocarditis include antibiotics and, in certain cases, surgery.
Endocarditis is uncommon in people with healthy hearts. People at greatest risk of endocarditis have damaged heart valves, artificial heart valves or other heart defects.
CAUSES
Endocarditis occurs when germs enter your bloodstream, travel to your heart, and attach to abnormal heart valves or damaged heart tissue. Bacteria cause most cases, but fungi or other microorganisms also may be responsible.
Sometimes the culprit is one of many common bacteria that live in your mouth, throat or other parts of your body. The offending organism may enter your bloodstream through:
- Everyday oral activities. Activities such as brushing your teeth or chewing food can allow bacteria to enter your bloodstream — especially if your teeth and gums aren’t healthy.
- An infection or other medical condition. Bacteria may spread from an infected area, such as a skin sore. Gum disease, a sexually transmitted infection or an intestinal disorder — such as inflammatory bowel disease — also may give bacteria the opportunity to enter your bloodstream.
- Catheters or needles. Bacteria can enter your body through a catheter — a thin tube that doctors sometimes use to inject or remove fluid from the body. The bacteria that can cause endocarditis can also enter your bloodstream through the needles used for tattooing or body piercing. Contaminated needles and syringes are a special concern for people who use intravenous (IV) drugs.
- Certain dental procedures. Some dental procedures that can cut your gums may allow bacteria to enter your bloodstream.
Usually, your immune system destroys bacteria that make it into your bloodstream. Even if bacteria reach your heart, they may pass through without causing an infection.
Most people who develop endocarditis have a diseased or damaged heart valve — an ideal spot for bacteria to settle. This damaged tissue in the endocardium provides bacteria with the roughened surface they need to attach and multiply. Endocarditis does occasionally occur on previously normal heart valves.
SYMPTOMS
Endocarditis may develop slowly or suddenly — depending on what’s causing the infection and whether you have any underlying heart problems. Endocarditis signs and symptoms vary, but may include:
- Fever and chills
- A new or changed heart murmur — heart sounds made by blood rushing through your heart
- Fatigue
- Aching joints and muscles
- Night sweats
- Shortness of breath
- Paleness
- Persistent cough
- Swelling in your feet, legs or abdomen
- Unexplained weight loss
- Blood in your urine (either visible or found in a doctor’s viewing of your urine under a microscope)
- Tenderness in your spleen — an infection-fighting abdominal organ on your left side, just below your rib cage
- Osler’s nodes — red, tender spots under the skin of your fingers
- Petechiae (puh-TEE-key-ee) — tiny purple or red spots on the skin, whites of your eyes or inside your mouth
When to see a doctor
If you develop signs or symptoms of endocarditis, see your doctor right away — especially if you have risk factors for this serious infection, such as a heart defect or a previous case of endocarditis.
Although less serious conditions can cause similar signs and symptoms, you won’t know for sure until you’re evaluated.
