What is Endocarditis? What are the Symptoms?
Endocarditis is a rare but serious infection that causes inflammation of the heart valves and chambers. If not treated quickly, this heart valve infection can cause damage to the lining of your heart valves and chambers, leaving you with life-limiting complications.
In this article, we explore what endocarditis is, what causes it, treatment options, and the common signs of endocarditis to look out for.
What is bacterial endocarditis?
Bacterial endocarditis is a potentially life-threatening inflammation of the inner lining (endocardium) of your heart valves and chambers. It is caused when bacteria enter your bloodstream and travel to your heart.
In healthy people, the heart is usually resistant to bacterial infections due to the body's natural protective functions. However, in people with heart damage, bacteria can attach to areas of the damage in the heart and cause endocarditis.
This heart valve infection can cause damage to your heart’s lining and chambers, resulting in serious, life-limiting heart complications.
Endocarditis can be fatal, and prompt treatment is needed to prevent damage to your heart valves and more serious complications.
Endocarditis treatment
Usually, immediate treatment involves being placed on a broad-spectrum intravenous (IV) antibiotic to cover as many suspected bacterium as possible. However, once doctors know which specific organism is causing your infection, they’ll adjust the antibiotic to ensure effective treatment. Often, IV antibiotics are required for up to six weeks to cure the infection.
If endocarditis damages your heart, you may also need surgery to repair your heart valve and improve your heart’s function. In addition, you may be prescribed prophylactic (preventative) antibiotics to prevent future infections.
What is infective endocarditis?
Infective endocarditis (IE) is a potentially fatal inflammation of the lining of the heart’s valves and chambers. It usually occurs when germs, most often bacteria but occasionally fungi, from elsewhere in your body enter the bloodstream and attach to and attack the lining of your heart valves and chambers.
Infective endocarditis causes growths on your heart valves, produces toxins and enzymes that kill and cause holes in your heart valves and can spread outside your heart and blood vessels. This can result in numerous complications, including:
- Leaky valve
- Heart block
- Abnormal heart rhythm
- Abscesses around the valve
- Heart failure
- Sepsis
- An embolism that disrupts blood flow
All these complications can be serious, and without treatment, infective endocarditis is a fatal disease.
What are endocarditis symptoms?
The symptoms of endocarditis vary from person to person. They can develop slowly or suddenly depending on the types of germs causing the infection and whether the individual has any existing heart problems.
Common signs of endocarditis include:
- Aching joints and muscles
- Chest pain when you breathe
- Fatigue
- Flu-like symptoms, such as fever and chills, which can come and go
- Night sweats
- Shortness of breath
- Swelling in the feet, legs, or belly
- A new heart murmur (often described as a whooshing sound)
Other less common symptoms can include:
- Unexplained weight loss
- Blood in the urine
- Tenderness in the spleen (typically felt as pain under the left rib cage)
- Painless red, purple, or brown flat spots on the soles of the feet or palms of the hands, known as Janeway lesions
- Painful red or purple bumps or patches of darkened skin on the tips of the fingers or toes, known as Osler nodes
- Tiny purple, red, or brown round spots on the skin, in the whites of the eyes, or the inside the mouth
Who does endocarditis affect?
Endocarditis can affect anyone, but it is more common in older people or those who have existing heart damage. This can include those with a:
- Birth defect of the heart
- Damaged or abnormal heart valve
- History of endocarditis
- New heart valve after surgery
- Intravenous drug use disorder or addiction
- Long-term intravenous line in place
However, it’s important to understand that even in people at higher risk of infection, endocarditis is a rare condition.
What causes endocarditis?
The most common cause of endocarditis is a bacterial infection. However, in some cases, fungi or other germs can be the cause.
Dental procedures, like tooth extractions and endoscopic examinations, are two common causes of bacterial endocarditis. However, bacteria can also enter your bloodstream from your mouth, skin, intestine, respiratory system, or urinary tract when you:
- Eat
- Brush your teeth
- Floss
- Pass a bowel movement
How is endocarditis diagnosed?
Endocarditis is diagnosed by clinicians who will review your symptoms and conduct a physical examination and diagnostic tests. The diagnostic tests used to provide an endocarditis diagnosis often include:
- Blood health profile test – this test can tell your doctor if you have an unusually high number of white blood cells, which may indicate an infection.
- Blood tests for substances like C-reactive protein, which can show inflammation.
- Blood cultures – these tests can show bacteria or microorganisms that healthcare providers often see with endocarditis.
- Echocardiogram – this is an ultrasound of the heart. It can show growths, abscesses or holes, leaks, stenosis (narrowing), or an artificial heart valve that is beginning to pull away from your heart tissues.
- Assessing heart valve tissues to discover the type of microbes causing the infection.
- Positron emission therapy (PET) scans – this type of scan uses a radioactive substance to create images that show the location of the infection.
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