Endocarditis is an inflammation of the endocardium (the inside lining of the heart chambers and heart valves) Endocarditis can involve the heart muscle, heart valves, or lining of the heart. Most people who develop endocarditis already have heart disease.
What causes endocarditis?
Endocarditis is usually caused by an infection of a microorganism. Bacterial infection is the most common source of endocarditis. However, it can also be caused by viruses, fungi, or other microorganisms.
Can endocarditis be prevented?
If you are at risk for endocarditis, your doctor may prescribe antibiotics for you to use prior to any dental or medical procedures, even something minor like getting your teeth cleaned. If you have had endocarditis before, continued follow-up with your doctor is advised.
What are the symptoms of endocarditis?
Symptoms can develop slowly or suddenly, and can include:
fatigue, weakness, fever, chills, night sweats, weight loss, muscle aches
heart murmur, shortness of breath, swelling of feet, legs, abdomen
blood in the urine, sweating, red skin spots located on the palms and soles (called Janeway lesions), paleness, nail abnormalities, joint pain, abnormal urine color,
red painful nodes in the pads of the fingers and toes (called Osler's nodes)
How is endocarditis diagnosed?
Your doctor will take your history and perform a physical exam. He/she may ask you if you have a history of congenital heart disease, i.v. drug use, or chronic localized abscess or infection. These items can increase your chances of getting endocarditis. Your doctor will look at the size of your spleen during the physical exam. Your doctor may examine your nails for signs of splinter hemorrhage, and your eyes for signs of retinal hemorrhage. Your doctor will listen for any new heart murmur, or a change in a previous heart murmur.
Certain diagnostic tests are useful in diagnosing endocarditis. They include:
Repeated blood culture and sensitivity (#1 test for detection)
ESR
CBC
echocardiogram
transesophageal echocardiogram
chest X-ray
CT scan of the chest
ASO
How is endocarditis treated?
Long term, high dose treatment with antibiotics is used to treat endocarditis. If heart valves are damaged by endocarditis and heart failure develops, surgery to replace the damaged heart valves may be required.
You will be required to rest in bed for the beginning of treatment. Activity can be gradually increased as your doctor allows. Your diet is not restricted, unless you are on a restricted diet for underlying heart disease.