What is endocarditis?

Endocarditis is an infection of the heart's valves or its inner lining (endocardium). It is most common in people who have a damaged, diseased, or artificial heart valve.

See a picture of endocarditis.

What causes endocarditis?

Endocarditis is caused by bacteria (or rarely, fungi) that enter the bloodstream and settle on the inside of the heart, usually on the heart valves. Bacteria can invade your bloodstream in many ways, including during some dental and surgical procedures. If you don't take care of your teeth, having your teeth cleaned or even brushing your teeth can cause bacteria to enter the bloodstream.

What increases the risk for endocarditis?

If you have a normal heart, you have a low risk for developing endocarditis. But if you have a problem with your heart that affects normal blood flow, it is more likely that bacteria or fungi will attach to heart tissue. This puts you at a high risk for endocarditis.

If you have certain heart conditions, getting endocarditis is even more dangerous for you. These heart conditions include:

• Artificial heart valves.
• Endocarditis in the past.
• Heart defects since birth (congenital heart defects).
• Heart valve problems after a heart transplant.

Other risk factors that put you at risk for getting endocarditis include:

• Having hypertrophic cardiomyopathy.
• Having hemodialysis, which is a treatment to clean the blood, for people with kidney failure.
• Injecting street drugs using dirty needles or without cleaning the skin.
• Having AIDS. Acquired immunodeficiency syndrome reduces your ability to fight infection.

What can you do if you are at risk for endocarditis?

Some heart problems can put you at risk for endocarditis. These heart conditions include:

• Artificial heart valves.
• Endocarditis in the past.
• Heart defects since birth (congenital heart defects).
• Heart valve problems after a heart transplant.

If you have any of these heart conditions, you may need to take antibiotics before you have certain dental and surgical procedures. The antibiotics lower your risk of getting endocarditis. These procedures include:

• Certain dental work or dental surgery.
• Lung surgery.
• Surgery on infected skin, bone, or muscle tissue.
• Certain medical procedures, such as a biopsy.

Maintaining good oral hygiene is especially important to prevent endocarditis if you are at risk.

Your doctor can give you a card to carry in your wallet that states that you need preventive antibiotics before certain procedures.

What are the symptoms?

The symptoms of endocarditis progress as the bacteria or fungi grow in your heart. Vague, flu-like symptoms, such as a low-grade fever and fatigue, often occur first. Most people with endocarditis begin to have symptoms within 2 weeks after becoming infected with bacteria or fungi.

But a powerful strain of bacteria may cause symptoms to appear much faster, within a few days.