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Endocarditis - MedlinePlus Medical Encyclopedia
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Endocarditis

Contents of this page:

Illustrations

Heart, section through the middle
Heart, section through the middle
Heart, front view
Heart, front view
Janeway lesion - close-up
Janeway lesion - close-up
Janeway lesion on the finger
Janeway lesion on the finger
Heart valves
Heart valves

Alternative Names    Return to top

Valve infection

Definition    Return to top

Endocarditis is inflammation of the inside lining of the heart chambers and heart valves (endocardium).

See also:

Causes    Return to top

Endocarditis can involve the heart muscle, heart valves, or lining of the heart. Most people who develop endocarditis have heart disease of the valves.

Risk factors for developing endocarditis include:

Bacterial infection is the most common source of endocarditis. However, it can also be caused by fungi. In some cases, no cause can be identified.

Symptoms    Return to top

Note: Endocarditis symptoms can develop slowly (subacute) or suddenly (acute).

Exams and Tests    Return to top

Doctors might suspect endocarditis in people with a history of:

The health care provider may detect a new heart murmur, or a change in a previous heart murmur. Examination of the nails may show splinter hemorrhages.

An eye exam may show bleeding in the retina a central area of clearing. This is known as Roth's spots. There may be small, pinpoint hemorrhages (petechiae) in the conjunctiva. The fingertips may be enlarged, and the nails may appear curved. This is called clubbing.

Tests:

Treatment    Return to top

People with this condition will often need to be hospitalized at first to receive antibiotics through a vein (intravenously). Long-term antibiotic therapy is needed to get the bacteria out of the heart chambers and valves.

Patients will usually have therapy for 6 weeks. The antibiotic must be specific for the organism causing the condition. This is determined by the blood culture and the sensitivity tests.

Surgery to replace the heart valve is usually needed when:

Outlook (Prognosis)    Return to top

Early treatment of endocarditis improves the chances of a good outcome. However, valve destruction or strokes can result in death.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call your health care provider if you notice the following symptoms during or after treatment:

Prevention    Return to top

People with certain heart conditions often take preventive antibiotics before dental procedures or surgeries involving the respiratory, urinary, or intestinal tract. Always ask your doctor if you think you may need them.

Those with a history of endocarditis should have continued medical follow-up.

References    Return to top

Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. London: Churchill Livingstone; 2005; pp 975-1022.

Karchmer AW. Infective Endocarditis. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007:chap 63.

Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007 Oct 9;116(15):1736-54.

Update Date: 9/3/2008

Updated by: D. Scott Smith, M.D., MSc, DTM&H, Chief of Infectious Disease & Geographic Medicine, Kaiser Redwood City, CA & Adjunct Assistant Professor, Stanford University.  Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2009, A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.


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