A potentially fatal inflammation of the inner lining of the heart's chambers and valves is known as endocarditis. The endocardium is the term for this lining.

Infection is frequently the cause of endocarditis. Once in circulation, bacteria, fungus, or other pathogens bind to the heart's injured parts. Artificial heart valves, broken heart valves, and other cardiac flaws increase your risk of developing endocarditis.

Endocarditis can harm or even destroy the heart valves if it isn't treated quickly. Medication and surgery are also options for treating endocarditis.

Endocarditis: Causes

Typically, infection with bacteria, fungus, or other pathogens leads to endocarditis. Once in the bloodstream, the germs move on to the heart. They cling to injured cardiac tissue or heart valves within the body.

Normally, any hazardous germs that enter the circulation are eliminated by the body's immune system. But, given the correct conditions, bacteria on the skin, in the mouth, throat, or stomach (intestines) might enter the circulation and result in endocarditis.

Endocarditis: Symptoms

Symptoms of endocarditis might differ from person to person. Endocarditis may develop slowly or quickly. If there are further cardiac issues or what kind of bacteria is causing the illness depends on these factors.

The following are typical signs of endocarditis −

  • Aching muscles and joints

  • During breathing, your chest hurts

  • Fatigue

  • Flu-like symptoms, such as fever and chills

  • Night sweats

  • Breathing difficulty

  • Swollen ankles, legs, or stomach

  • A different or fresh whooshing in the heart (murmur)

Symptoms of endocarditis that are less typical include −

  • Unaccounted-for weight loss

  • Blood in the urine

  • Beneath the left rib cage, a soreness (spleen)

  • On the palms of the hands or the bottoms of the feet, there are flat, painless red, purple, or brown blotches (Janeway lesions)

  • Hyperpigmented (darkened) skin patches or painful red, purple, or purple lumps on the ends of the fingers or toes (Osler nodes)

  • Petechiae, are tiny purple, red, or brown spots that appear on the skin, the whites of the eyes, or the inside of the mouth.

When to Visit a Doctor?

See your doctor as soon as you can if you exhibit signs of endocarditis, especially if you have a congenital heart defect or a history of endocarditis. Similar signs and symptoms may be brought on by less serious illnesses. The diagnosis can only be made after a qualified examination by a healthcare professional.

If you've been diagnosed with endocarditis and have any of the following symptoms, inform your care provider. Some signs of a worsening infection include these −

  • Chills

  • Fever

  • Headaches

  • Aching joints

  • Breathing difficulty

Endocarditis: Risk Factors

Several factors play an important role in the development of endocarditis which includes −

  • Age. Those over the age of 60 are more likely to develop endocarditis.

  • Artificial heart valves. Germs are more prone to adhere to an artificial (prosthetic) heart valve than to a conventional heart valve.

  • Heart valve damage. Certain medical conditions, such as rheumatic fever or infection, can damage or scar one or more of the heart valves, increasing the risk of infection. Further raising the risk of infection is a history of endocarditis.

  • Inherited cardiac problems. Heart infections are more likely among people who were born with certain cardiac problems, such as an irregular heartbeat or damaged heart valves.

  • Heart-implanted gadget. Bacteria can cling to an implanted device, such as a pacemaker, causing an infection of the heart's lining.

  • Injecting illicit drugs. Infections like endocarditis can result from the use of contaminated IV needles. Those who use illicit IV narcotics, such as heroin or cocaine, should pay particular attention to contaminated needles and syringes.

  • Dental problems. Good oral and gum health is necessary for overall wellness. Bacteria can grow in your mouth and perhaps enter your bloodstream via a wound on your gums if you don't routinely brush and floss. Gums can be cut during several dental operations, which increases the risk of germs entering circulation.

  • The prolonged usage of catheters. A catheter is a small tube used during some medical operations. Endocarditis risk is increased when an indwelling catheter is left in place for an extended period.

Endocarditis: Diagnosis

The diagnosis of endocarditis is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes −

  • Blood culture test. This examination identifies microorganisms in the bloodstream. The antibiotic or combination of antibiotics to be used for therapy is decided upon using the test's results.

  • Thorough blood count. If there are a lot of white blood cells, it may indicate an infection, according to this test.

  • Echocardiogram. Sound waves are employed to produce visualizations of the beating heart.

  • Electrocardiogram (ECG or EKG). This simple and painless examination examines the electrical activity of the heart.

  • A chest X-ray. The health of the heart and lungs may be seen on a chest X-ray.

  • Either a magnetic resonance imaging (MRI) scan or a computer tomography scan (MRI).

Endocarditis: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Conservative Treatment

Antibiotics are a common and effective treatment for endocarditis. Sometimes, surgery may be needed to correct or replace damaged heart valves and clear up any lingering traces of the infection.

Bacterial endocarditis is treated with high doses of IV antibiotics. If you take IV antibiotics, you will often stay in the hospital for a week or more so that medical professionals can assess how well the therapy is working.

If your fever and other severe symptoms have gone completely, you might be allowed to leave the hospital. Some patients continue IV antibiotics while receiving treatment at home or in the doctor's office. Antibiotics are frequently used for several weeks.

Surgical Treatment

Surgery to repair a damaged valve or treat recurrent endocarditis infections may be required. In certain cases, surgery is required to cure endocarditis brought on by a fungus.

Endocarditis: Prevention

Some of the measures that can help to prevent endocarditis include −

  • Understand the symptoms and indications of endocarditis. If you experience any signs of infection, especially a fever that won't go away, unexplained lethargy, any kind of skin infection, or open wounds or sores that don't heal correctly, see your doctor right soon.

  • Take good care of your gums and teeth. You should regularly floss and brush your teeth. Obtain frequent dental checks. Proper dental hygiene is a vital aspect of preserving your overall health.

  • Use no illicit Intravenous drugs. By introducing germs into the circulation, dirty needles raise the risk of endocarditis.


When bacteria or other pathogens get into circulation and go to the heart, endocarditis occurs. The bacteria then adhere to cardiac tissue or damaged heart valves. Endocarditis is a life-threatening inflammation of the inner lining of the heart's chambers and valves. The endocardium is the term for this lining.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha


Updated on: 18-Apr-2023


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