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Alternative Names Return to topValve infection
Definition Return to top
Endocarditis is inflammation of the inside lining of the heart chambers and heart valves (endocardium).
Causes Return to top
Endocarditis can involve the heart muscle, heart valves, or lining of the heart. Most people who develop endocarditis have heart disease of the valves.
Risk factors for developing endocarditis include:
Bacterial infection is the most common source of endocarditis. However, it can also be caused by fungi. In some cases, no cause can be identified.
Symptoms Return to top
Note: Endocarditis symptoms can develop slowly (subacute) or suddenly (acute).
Exams and Tests Return to top
Doctors might suspect endocarditis in people with a history of:
The health care provider may detect a new heart murmur, or a change in a previous heart murmur. Examination of the nails may show splinter hemorrhages.
An eye exam may show bleeding in the retina a central area of clearing. This is known as Roth's spots. There may be small, pinpoint hemorrhages (petechiae) in the conjunctiva. The fingertips may be enlarged, and the nails may appear curved. This is called clubbing.
Treatment Return to top
People with this condition will often need to be hospitalized at first to receive antibiotics through a vein (intravenously). Long-term antibiotic therapy is needed to get the bacteria out of the heart chambers and valves.
Patients will usually have therapy for 6 weeks. The antibiotic must be specific for the organism causing the condition. This is determined by the blood culture and the sensitivity tests.
Surgery to replace the heart valve is usually needed when:
Outlook (Prognosis) Return to top
Early treatment of endocarditis improves the chances of a good outcome. However, valve destruction or strokes can result in death.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your health care provider if you notice the following symptoms during or after treatment:
Prevention Return to top
People with certain heart conditions often take preventive antibiotics before dental procedures or surgeries involving the respiratory, urinary, or intestinal tract. Always ask your doctor if you think you may need them.
Those with a history of endocarditis should have continued medical follow-up.
References Return to top
Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. London: Churchill Livingstone; 2005; pp 975-1022.
Karchmer AW. Infective Endocarditis. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007:chap 63.
Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007 Oct 9;116(15):1736-54.Update Date: 9/3/2008 Updated by: D. Scott Smith, M.D., MSc, DTM&H, Chief of Infectious Disease & Geographic Medicine, Kaiser Redwood City, CA & Adjunct Assistant Professor, Stanford University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.