ENDOCARDITIS

(Bacterial Endocarditis; Infective Endocarditis)

 Basic information

description

Endocarditis is an infection and inflammation involving the endocardium (the inner lining of the heart chambers). It typically involves the heart valves also. It can develop slowly or suddenly. Older adults are more often affected.

FREQUENT SIGNS & SYMPTOMS

• Fatigue and weakness.
• Recurrent fever, chills, and heavy sweating, especially at night.
• Loss of appetite and weight loss.
• Vague muscle aches and joint pains.
• Headache.
• Blood in the urine.
• Cough; shortness of breath.
• Swelling of the feet, legs, and stomach.
• Fast or irregular heartbeat.
• Red spots on the skin (e.g., fingers and toes).

causes

An infection (usually bacterial, sometimes fungal) that enters the bloodstream and infects the heart valves. The infection may start with a skin disorder or injury, a medical or dental procedure, or a skin prick (as with an IV drug user).

risk increases with

• History of endocarditis or rheumatic heart disease.
• Congenital (being born with) heart disease.
• IV (intravenous) drug abuse.
• Heart valve problems.
• Weak immune system due to illness or drugs.
• Artificial heart valves or other artificial devices in the heart, such as a pacemaker wire.

PREVENTIVE MEASURES

• If you have heart-valve damage or a heart murmur, ask about antibiotic use before medical procedures that may bring bacteria into the blood. These include dental work, childbirth, and some surgeries.
• Once you have had endocarditis, follow your health care provider's advice about preventing a relapse.
• Don't abuse IV drugs.

expected outcomes

Usually curable with early diagnosis and treatment. Recovery can take weeks. If untreated, or if treatment is delayed, heart function declines resulting in serious complications.

possible complications

• Heart problems, including heart attack, congestive heart failure, arrhythmias, and others.
• Blood clots may break off and travel to other places in the body, such as the brain or kidneys.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask questions about your symptoms. Medical tests may include blood studies, echocardiogram and electrocardiogram (heart function tests), x-rays, and CT.
• Treatment usually involves drugs for the infection, supportive care for symptoms, and steps to prevent complications.
• Hospital care is normally needed during acute phase. Once stable, some patients can continue with treatment at home.
• Surgery may be done to replace an infected heart valve in some patients.
• IV drug abusers may require special medical care and should receive drug abuse counseling.
• Wear a medical alert bracelet or neck tag that states you have had this medical problem.

medications

Antibiotics (for a bacterial infection) will be prescribed. They are normally needed for 2 to 6 weeks. Antibiotic treatment is often given through a vein (IV), but in some cases may be taken orally.

activity

• Rest in bed until fully recovered. While in bed, move your legs often to help prevent clots from forming in deep veins.
• Resume your normal activities, including sexual relations, when strength allows or upon medical advice.

diet

No special diet.

 notify our office if

• You or a family member has symptoms of endocarditis.
• The following occur during or after treatment:
  • Weight gain without diet changes.
  • Blood in the urine.
  • Chest pain or shortness of breath.
  • Sudden weakness or numbness in muscles of the face, trunk, or limbs.

Special Notes: