Understanding Endocarditis (Heart Infection)

Endocarditis is the infection of the inner lining of your heart chambers and its valves, collectively called the endocardium. Often a rare occurrence, endocarditis develops when bacteria or fungi spread from another part of your body and enters your heart via the bloodstream; they latches onto the damaged tissues of your heart, and starts causing trouble.

The onset of symptoms depends on the cause of infection. It can either be slow or rapid. Moreover, an underlying heart condition may affect the onset and severity of symptoms.

What Happens in Endocarditis? Watch Out for These Symptoms

The symptoms may vary from person to person.  It often starts with mild symptoms, and slowly progress into more serious ones. The mild symptoms can often be mistaken for symptoms of other diseases.

Here are the most common symptoms:

•     Fever and chills
•     A heart murmur
•     Tiredness and fatigue
•     Aching joints and muscles
•     Night sweats
•     Difficulty breathing with chest pain
•     Swelling of the abdomen, legs or feet

Endocarditis may also cause symptoms that are out of the ordinary like: 

• Unexpected weight loss, with no definite cause
• Blood in urine; this may only be visible under a microscope
• Tender, red spots on the toes and fingers
• Tenderness just below your rib cage where your spleen is located (upper left abdomen)
• Red spots on your feet and palms (Janeway lesions)
• Red or purple spots on the skin, inside your mouth, or the whites of your eyes

As its symptoms may exhibit itself differently in different people, there might be symptoms that were not listed above. If you happen to have these set of symptoms, or have a suspicion that you may have endocarditis, consult your doctor.

What Are the Causes of Endocarditis?

Endocarditis is often caused by bacteria that enter the bloodstream via the mouth or open wounds. These then enter the heart where they attach themselves to damaged tissues. While bacteria is its most common cause, fungi and other microorganisms can also cause endocarditis.

These causative agents can enter your bloodstream through:

• Mouth and gums. Brushing your teeth aggressively and some dental procedures can cut your gums and cause them to bleed. 
• Skin sores and open wounds 
• Medical conditions such as gum disease, STIs, and inflammatory bowel disease
• Catheters, especially when used for a long time
• Tattoos and body piercing 
• Contaminated needles and syringes

What Are the Risk Factors of Endocarditis?

Damaged or broken tissues of the heart muscles are more prone to infection. However, while it primarily affects those with damaged heart valves, endocarditis can also occur in healthy people.

Those at higher risk of developing endocarditis are those with:

•     Damaged heart valves
•     Congenital heart defects
•     Artificial heart valves
•     History of endocarditis
•     History of illegal drug use, especially those who use contaminated needles

Is Endocarditis Treatable? 

Though it attacks one of the most vital organs in the body, in many cases, endocarditis can be treated with simple antibiotics. But in more serious cases, a physician may prescribe surgery. This is to clean up the area where the bacteria has spread—ensuring that it doesn’t recur, or to replace a damaged valve.

For artificial valve replacement, it can either be mechanical or formed from cow, pig or human tissue. 

How Is Endocarditis Diagnosed?

First, you must remember that you cannot diagnose yourself, and that you cannot diagnose it at home.

So how is endocarditis diagnosed? Typically, your doctor will perform a physical exam along with a review of the patient’s medical history. Based on that, he or she will then have a suspicion if it is endocarditis or not. Your doctor may then order several blood tests to help confirm the diagnosis.

Blood culture tests will help identify as to what is the causative agent of your condition. Depending on the organism, the doctor will prescribe the best antibiotic treatment for you.

In addition to a blood culture test, your doctor may request the following:  

• Echocardiogram. A test that uses sound waves to produce an image of your heart, which can help check for structure of the heart that might be affected by the infection.
• Electrocardiogram (ECG). This scan can detect irregularities in your heart’s electrical activity, confirming possible damage to the heart valve. 
• Chest x-ray. This is used to check if the infection has spread to your lungs, and whether your heart has become enlarged due to infection. 
• CT (computerized tomography) scan or MRI (magnetic resonance imaging). For more serious infections, an MRI or CT scan may be required to check whether it has spread to other vital parts of the body like your brain. 

Typically, the ill patient will spend a few days to a week in the hospital to receive IV antibiotics. In addition to this, the doctor will place the patient under medical supervision to ensure that they respond positively to the treatment. Antibiotic therapy can later be continued at home for another couple of weeks.

How Can You Lower Your Risk of Endocarditis?

As the cause of endocarditis is bacteria, fungi, or microorganisms, you can follow a few preventive measures to minimize your risk of developing an infection that can cause endocarditis:

• Maintain good dental health by regularly going to your dentist, and brushing and flossing regularly. 
• Avoid getting tattoos and body piercings, which can lead to skin infections.
• Immediately clean wounds and take care of open sores. 

If you notice symptoms that may point to endocarditis, consult your doctor immediately.

Learn more about Heart Health here.