Heart Disease Health Center

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 in rare cases, by 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 endocarditis. But if you have a problem with your heart that affects normal blood flow through the heart , it is more likely that bacteria or fungi will attach to heart tissue. This puts you at a higher risk for endocarditis.

You have a higher risk of endocarditis if you have:

• Had endocarditis in the past.
• Hemodialysis for kidney failure.
• Abnormal or damaged heart valves.
• An artificial heart valve.
• A congenital heart defect.
• Hypertrophic cardiomyopathy.
• Injected illegal drugs using dirty needles or without cleaning the skin.
• HIV.

Not all heart problems give you a higher risk of endocarditis. You do not have a higher risk if you have:

• Coronary artery bypass graft surgery (bypass surgery).
• Previous rheumatic fever without heart valve damage.
• A pacemaker or an implantable cardioverter-defibrillator (ICD).
• A heart attack without other complications.
• Mitral valve prolapse without mitral valve regurgitation or unusually thickened valve leaflets.
• A coronary artery stent.

What can you do if you are at 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.

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. If you do not have these conditions, antibiotics are not likely to help you.

Procedures that may require antibiotics include:

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

Practicing 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. The card states that you may 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.