Overview of Endocarditis

Endocarditis is an infection that affects the inner lining of the heart chambers and valves it is known as the endocardium. This serious condition occurs when harmful bacteria or other microorganisms invade the heart, leading to inflammation. It can cause severe damage to heart valves, heart failure or other life-threatening complications if left untreated. Infective endocarditis is the most common type of this disease and requires immediate medical attention.

Types of Endocarditis

There are several types of endocarditis each of them differing in the severity, causative organisms and clinical presentation:


1. Infective endocarditis: Caused by bacteria or fungi, most commonly in individuals with pre existing heart conditions.

2. Subacute bacterial endocarditis: A slower progression of infective endocarditis which often affects those with existing heart defects.

3. Libman-Sacks endocarditis: Associated with autoimmune diseases such as lupus.

4. Marantic endocarditis: Also known as nonbacterial thrombotic endocarditis (NBTE) which is often linked with cancer.

5. HACEK endocarditis: A rare form of bacterial endocarditis caused by the HACEK group of bacteria.

Symptoms of Endocarditis

  • Persistent Fever: A high, unrelenting fever is often the first warning sign.
  • Fatigue and Weakness: Feeling unusually tired or weak, even after rest, can be an early symptom.
  • Heart Murmur: A new or changed heart murmur may indicate endocarditis.
  • Swelling in Limbs: Unexplained swelling in the legs, feet or abdomen can be a result of heart problems.
  • Painful Nodules: Osler’s nodes, painful red or purple lumps on fingers or toes are a tell tale sign.
  • Painless Spots: Janeway lesions, small, painless spots on palms or soles can appear in severe cases.
  • Night Sweats: Excessive sweating at night can accompany fever and fatigue.
  • Shortness of Breath: Difficulty breathing especially during physical activity, may occur as the heart’s function declines.

Causes of Endocarditis

  • Bacterial Infections: The most common cause is bacteria entering the bloodstream, especially through dental procedures or IV drug use.
  • Heart Valve Damage: People with existing heart conditions like valve defects are at higher risk.
  • Poor Oral Hygiene: Untreated gum disease or tooth infections can lead to endocarditis.
  • Intravenous Drug Use: Sharing needles or using contaminated drugs can introduce bacteria directly into the bloodstream.
  • Implants and Medical Devices: Pacemakers or artificial heart valves can provide an entry point for bacteria.

Complications in Endocarditis

  • Heart Valve Damage: Prolonged infection can lead to irreversible damage to heart valves and potentially require surgery.
  • Heart Failure: The infection weakens the heart and makes it difficult for it to pump blood efficiently.
  • Stroke: If infected clots break off, they can travel to the brain and cause a stroke.
  • Kidney Damage: The infection can spread to the kidneys which leads to kidney failure.
  • Septicemia: Untreated endocarditis can cause blood poisoning, leading to widespread infection throughout the body.

Risk Factors of Endocarditis

  • Existing Heart Conditions: People with heart valve disease or congenital heart defects are more prone to endocarditis.
  • Prosthetic Heart Valves: Artificial heart valves are more vulnerable to infections.
  • Intravenous Drug Use: Sharing needles increases the risk of introducing harmful bacteria into the bloodstream.
  • Recent Dental Procedures: Bacteria from the mouth can enter the bloodstream during dental work.
  • Weakened Immune System: Those with compromised immunity are more vulnerable to infections.
  • Chronic Conditions: Conditions like diabetes or cancer can increase the likelihood of endocarditis.

Preventions of Endocarditis

  • Good Oral Hygiene: Regular brushing, flossing and dental check-ups can prevent infections that may lead to endocarditis.
  • Antibiotic Prophylaxis: Those at high risk should take antibiotics before dental or surgical procedures.
  • Avoid Intravenous Drug Use: Reducing or eliminating IV drug use minimizes the risk of infection.
  • Manage Heart Conditions: Regular check ups and medications can help manage heart disease and prevent complications.
  • Strengthen Immune System: A healthy diet and lifestyle help keep your immune system strong.

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