Most people with endocarditis have symptoms that begin within 2 weeks after becoming infected. Vague, flu-like symptoms, such as a low-grade fever and fatigue, often occur first. But infection with a powerful strain of bacteria may cause symptoms to be more severe (such as a high fever) and to appear much faster, within a few days. If symptoms persist, see your doctor, especially if you are at a high risk for endocarditis.

Symptoms include:

• Chills and fever.
• Fatigue.
• Weight loss.
• Night sweats.
• Painful joints.
• Persistent cough and shortness of breath.
• Bleeding under the fingernails.
• Tiny purple and red spots under the skin, called petechiae.

You are at increased risk if you have certain heart conditions, including:

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

Other risk factors 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.

Your primary doctor can tell you whether you are at increased risk for endocarditis. Tell all other health professionals who treat you that you are at risk for endocarditis before you have any medical, dental, or surgical procedures. Your doctor can give you a card to carry in your wallet that states that you need preventive antibiotics before having certain procedures.

Symptoms of heart failure may develop if a heart valve is severely damaged.