ENDOCARDITIS

General Information

DEFINITION--A non-contagious infection of the valves or lining of the heart.

BODY PARTS INVOLVED--Heart muscle; heart valves; endocardium (lining of the heart chambers and valves).

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

Early symptoms:

• Fatigue and weakness.
• Intermittent fever, chills and excessive sweating, especially at night.
• Weight loss.
• Vague aches and pains.
• Heart murmur.

Late symptoms:

• Severe chills and high fever.
• Shortness of breath on exertion.
• Swelling of the feet, legs and abdomen.
• Rapid or irregular heartbeat.

CAUSES--Bacteria or fungi that enter the blood and infect the valves and heart lining of persons with damaged hearts (see risks below). Bacteria or fungi further damage the heart valves, muscles and linings.

RISK INCREASES WITH

Risk of heart-valve damage increases with:

• Rheumatic fever.
• Congenital heart disease.

Risk of endocarditis following heart-valve damage increases with:

• Pregnancy.
• Injections of contaminated materials into the bloodstream, such as with self-administered intravenous drugs.
• Excess alcohol consumption.
• Use of immunosuppressive drugs.
• Artificial heart valves.

HOW TO PREVENT--

If you have heart-valve damage or a heart murmur:

• Request antibiotics prior to medical procedures that may introduce bacteria into the blood. These include dental work, childbirth and surgery of the urinary or gastrointestinal tract.
• Don't drink more than 1 or 2--if any--alcoholic drinks in 1 day.
• Consult your doctor before becoming pregnant.
• Don't use illicit drugs like heroin or cocaine.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and physical exam by a doctor.
• Your own observation of symptoms.
• Laboratory blood counts and blood cultures.
• ECG (See Glossary).
• X-rays of the heart and lungs, including echocardiogram (See Glossary).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization.
• Self-care after the acute illness.
• Surgery to replace infected valve in some patients.

POSSIBLE COMPLICATIONS

• Blood clots that may travel to the brain, kidneys or abdominal organs, causing infections, abscesses or stroke.
• Heart-rhythm disturbances (atrial fibrillation is most common).

PROBABLE OUTCOME--Usually curable with early diagnosis and treatment, but recovery may take weeks. If treatment is delayed, heart function deteriorates, resulting in congestive heart failure and possible death.

How To Treat

GENERAL MEASURES--

• If you have damaged heart valves, tell any doctor or dentist who treats you.
• Once you have had endocarditis, stay under a doctor's care to prevent a relapse.
• Ongoing dental hygiene is important to prevent infection.
• Wear a medical alert type bracelet or neck tag that indicates your medical problem. Carry a wallet card listing the antibiotic regimens needed for medical and dental procedures.

MEDICATION--Your doctor may prescribe antibiotics for many weeks to fight infection. Antibiotic treatment is often intravenous.

ACTIVITY--Rest in bed until you are fully recovered. While in bed, flex your legs often to prevent clots from forming in deep veins. Resume your normal activities, including sexual relations, when strength allows.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of endocarditis.
• The following occurs during or after treatment: Weight gain without diet changes. Blood in the urine. Chest pain. Sudden weakness or numbness in muscles of the face, trunk or limbs.