Endocarditis - Symptoms and causes - Mayo Clinic

Endocarditis is a life-threatening inflammation of the inner lining of your heart's chambers and valves (endocardium). COVID-19:Advice,updatesandvaccineoptions Weareopenforsafein-personcare. Learnmore: MayoClinicfactsaboutcoronavirusdisease2019(COVID-19) OurCOVID-19patientandvisitorguidelines,plustrustedhealthinformation Lateston COVID-19vaccination bysite: Arizonapatientvaccinationupdates Arizona, Floridapatientvaccinationupdates Florida, Rochesterpatientvaccinationupdates Rochesterand MayoClinicHealthSystempatientvaccinationupdates MCHS Skiptositenavigation SkiptoContent ThiscontentdoesnothaveanEnglishversion.ThiscontentdoesnothaveanArabicversion. SectionsforEndocarditisSymptoms&causesDiagnosis&treatmentDoctors&departments Print Overview Endocarditis Openpop-updialogbox Close Endocarditis Endocarditis Endocarditisoccurswhenbacteriaorothergermsenteryourbloodstream,traveltoyourheart,andlodgeonabnormalheartvalvesordamagedhearttissue.Abnormalgrowths(vegetations)thatcontaincollectionsofbacteriamayforminyourheartatthesiteoftheinfectionanddamagetheheartvalves,whichcancausethemtoleak. Endocarditisisalife-threateninginflammationoftheinnerliningofyourheart'schambersandvalves(endocardium). Endocarditisisusuallycausedbyaninfection.Bacteria,fungiorothergermsfromanotherpartofyourbody,suchasyourmouth,spreadthroughyourbloodstreamandattachtodamagedareasinyourheart.Ifit'snottreatedquickly,endocarditiscandamageordestroyyourheartvalves.Treatmentsforendocarditisincludemedicationsand,sometimes,surgery. Peopleatgreatestriskofendocarditisusuallyhavedamagedheartvalves,artificialheartvalvesorotherheartdefects. SymptomsEndocarditismaydevelopslowlyorsuddenly,dependingonwhatgermsarecausingtheinfectionandwhetheryouhaveanyunderlyingheartproblems.Signsandsymptomsofendocarditiscanvaryfrompersontoperson. Commonsignsandsymptomsofendocarditisinclude: Achingjointsandmuscles Chestpainwhenyoubreathe Fatigue Flu-likesymptoms,suchasfeverandchills Nightsweats Shortnessofbreath Swellinginyourfeet,legsorabdomen Aneworchangedheartmurmur,whichistheheartsoundmadebybloodrushingthroughyourheart Lesscommonsignsandsymptomsofendocarditiscaninclude: Unexplainedweightloss Bloodinyoururine,whichyoumightbeabletoseeorthatyourdoctormightseewhenheorsheviewsyoururineunderamicroscope Tendernessinyourspleen,whichisaninfection-fightingorganlocatedjustbelowyourleftribcage Redspotsonthesolesofyourfeetorthepalmsofyourhands(Janewaylesions) Red,tenderspotsundertheskinofyourfingersortoes(Osler'snodes) Tinypurpleorredspots,calledpetechiae(puh-TEE-kee-ee),ontheskin,inthewhitesofyoureyesorinsideyourmouth WhentoseeadoctorIfyouhavesignsorsymptomsofendocarditis,seeyourdoctorassoonaspossible—especiallyifyouhaveriskfactorsforthisseriousinfection,suchasaheartdefectorhistoryofendocarditis.Althoughlessseriousconditionscancausesimilarsignsandsymptoms,youwon'tknowforsureuntilyou'reevaluatedbyyourdoctor. Ifyou'vebeendiagnosedwithendocarditis,tellyourdoctoraboutanysignsorsymptomsthatmaymeanyourinfectionisgettingworse,suchas: Chills Fever Headaches Jointpain Shortnessofbreath Ifyou'rebeingtreatedwithantibioticsforendocarditis,tellyourdoctorifyoudevelopdiarrhea,arash,itchingorjointpain.Thesesignsandsymptomsmaymeanyou'rehavingareactiontoyourprescribedantibiotic. RequestanAppointmentatMayoClinic CausesEndocarditisoccurswhengerms,usuallybacteria,enteryourbloodstream,traveltoyourheart,andattachtoabnormalheartvalvesordamagedhearttissue.Fungiorothergermsalsomaycauseendocarditis. Usually,yourimmunesystemdestroysanyharmfulbacteriathatenteryourbloodstream.However,bacteriathatliveinyourmouth,throatorotherpartsofyourbody,suchasyourskinoryourgut,cansometimescauseendocarditisundertherightcircumstances. Bacteria,fungiandothergermsthatcauseendocarditismightenteryourbloodstreamthrough: Improperdentalcare.Propertoothbrushingandflossinghelpspreventgumdisease.Ifyoudon'ttakegoodcareofyourteethandgums,brushingcouldcauseunhealthygumstobleed,givingbacteriaachancetoenteryourbloodstream.Somedentalproceduresthatcancutyourgumsalsomayallowbacteriatoenteryourbloodstream. Catheters.Bacteriacanenteryourbodythroughathintubethatdoctorssometimesusetoinjectorremovefluidfromthebody(catheter).Thisismorelikelytooccurifthecatheterisinplaceforalongperiodoftime.Forexample,youmayhaveacatheterifyouneedlong-termdialysis. IllegalIVdruguse.ContaminatedneedlesandsyringesareaspecialconcernforpeoplewhouseillegalIVdrugs,suchasheroinorcocaine.Often,individualswhousethesetypesofdrugsdon'thaveaccesstoclean,unusedneedlesorsyringes. Riskfactors Chambersandvalvesoftheheart Openpop-updialogbox Close Chambersandvalvesoftheheart Chambersandvalvesoftheheart Atypicalhearthastwoupperandtwolowerchambers.Theupperchambers—therightandleftatria—receiveincomingblood.Thelowerchambers—therightandleftventricles—pumpbloodoutofyourheart.Theheartvalves,whichkeepbloodflowingintherightdirection,aregatesatthechamberopenings(forthetricuspidandmitralvalves)andexits(forthepulmonaryandaorticvalves). You'remorelikelytodevelopendocarditisifyouhavefaulty,diseasedordamagedheartvalves.However,endocarditisdoesoccasionallyoccurinpreviouslyhealthypeople. Youhaveanincreasedriskofendocarditisifyouhave: Olderage.Endocarditisoccursmostofteninolderadultsoverage60. Artificialheartvalves.Germsaremorelikelytoattachtoanartificial(prosthetic)heartvalvethantoanormalheartvalve. Damagedheartvalves.Certainmedicalconditions,suchasrheumaticfeverorinfection,candamageorscaroneormoreofyourheartvalves,increasingtheriskofinfection. Congenitalheartdefects.Ifyouwerebornwithcertaintypesofheartdefects,suchasanirregularheartorabnormalheartvalves,yourheartmaybemoresusceptibletoinfection. Implantedheartdevice.Bacteriacanattachtoanimplanteddevice,suchasapacemaker,causinganinfectionoftheheart'slining. Ahistoryofendocarditis.Endocarditiscandamagehearttissueandvalves,increasingtheriskofafutureheartinfection. AhistoryofillegalIVdruguse.Peoplewhouseillegaldrugsbyinjectingthemareatagreaterriskofendocarditis.Theneedlesusedtoinjectdrugscanbecontaminatedwiththebacteriathatcancauseendocarditis. Poordentalhealth.Ahealthymouthandhealthygumsareessentialforgoodhealth.Ifyoudon'tbrushandflossregularly,bacteriacangrowinsideyourmouthandmayenteryourbloodstreamthroughacutonyourgums. Long-termcatheteruse.Havingacatheterinplaceforalongperiodoftime(indwellingcatheter)increasesyourriskofendocarditis. Ifyou'reatriskofendocarditis,letallofyourdoctorsknow.YoumaywanttorequestanendocarditiswalletcardfromtheAmericanHeartAssociation.Checkwithyourlocalchapterorprintthecardfromtheassociation'swebsite. ComplicationsInendocarditis,clumpsmadeofgermsandcellpiecesformanabnormalmassinyourheart.Theseclumps,calledvegetations,canbreaklooseandtraveltoyourbrain,lungs,abdominalorgans,kidneys,orarmsandlegs. Asaresult,endocarditiscancauseseveralcomplications,including: Heartproblems,suchasheartmurmur,heartvalvedamageandheartfailure Stroke Pocketsofcollectedpus(abscesses)thatdevelopintheheart,brain,lungsandotherorgans Bloodclotinalungartery(pulmonaryembolism) Kidneydamage Enlargedspleen PreventionYoucantakethefollowingstepstohelppreventendocarditis: Knowthesignsandsymptomsofendocarditis.Seeyourdoctorimmediatelyifyoudevelopanysignsorsymptoms,especiallyafeverthatwon'tgoaway,unexplainedfatigue,anytypeofskininfection,oropencutsorsoresthatdon'thealproperly. Takecareofyourteethandgums.Brushandflossyourteethandgumsoften,andhaveregulardentalcheckups.Gooddentalhygieneisanimportantpartofmaintainingyouroverallhealth. Don'tuseillegalIVdrugs.Dirtyneedlescansendbacteriaintoyourbloodstream,increasingyourriskofendocarditis. PreventiveantibioticsCertaindentalandmedicalproceduresmayallowbacteriatoenteryourbloodstream. Ifyou'reathighriskofendocarditis,theAmericanHeartAssociationrecommendstakingantibioticsanhourbeforehavinganydentalworkdone. You'reathighriskofendocarditisandneedantibioticsbeforedentalworkifyouhave: Ahistoryofendocarditis Aman-made(prostheticmechanical)heartvalve Ahearttransplant,insomecases Certaintypesofcongenitalheartdisease Congenitalheartdiseasesurgeryinthelastsixmonths Ifyouhaveendocarditisoranytypeofcongenitalheartdisease,talktoyourdoctoranddentistaboutyourrisksandwhetheryouneedpreventiveantibiotics. ByMayoClinicStaff RequestanAppointmentatMayoClinic Diagnosis&treatment Nov.14,2020 Print Shareon:FacebookTwitter Showreferences Heartinflammation.NationalHeart,Lung,andBloodInstitute.https://www.nhlbi.nih.gov/health-topics/heart-inflammation.AccessedOct.9,2020. JamesonJL,etal.,eds.Infectiveendocarditis.In:Harrison'sPrinciplesofInternalMedicine.20thed.McGrawHill;2018.https://accessmedicine.mhmedical.com.AccessedOct.9,2020. SextonDJ,etal.Epidemiology,riskfactors,andmicrobiologyofinfectiveendocarditis.https://www.uptodate.com/contents/search.AccessedOct.8,2020. SextonDJ,etal.Clinicalmanifestationsandevaluationofadultswithsuspectedleft-sidednativevalveendocarditis.https://www.uptodate.com/contents/search.AccessedOct.8,2020. SpelmanD,etal.Complicationsandoutcomeofinfectiveendocarditis.https://www.uptodate.com/contents/search.AccessedOct.8,2020. SextonDJ,etal.Antimicrobialtherapyofleft-sidednativevalveendocarditis.https://www.uptodate.com/contents/search.AccessedOct.8,2020. Heartvalvesandinfectiveendocarditis.AmericanHeartAssociation.https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-problems-and-causes/heart-valves-and-infective-endocarditis#.WOUJ42czXIV.AccessedOct.8,2020. Infectiveendocarditis.AmericanHeartAssociation.https://www.heart.org/en/health-topics/infective-endocarditis.AccessedOct.12,2020. CahillTJ,etal.Challengesininfectiveendocarditis.JournaloftheAmericanCollegeofCardiology.2017;doi:10.1016/j.jacc.2016.10.066. AskMayoExpert.Infectiveendocarditis.MayoClinic;2019. Antibioticprophylaxispriortodentalprocedures.AmericanDentalAssociation.https://www.ada.org/en/member-center/oral-health-topics/antibiotic-prophylaxis.AccessedOct.9,2020. VincentLL,etal.Infectiveendocarditis:Updateonepidemiology,outcomes,andmanagement.CurrentCardiologyReports.2018;doi:10.1007/s11886-018-1043-2. MankadR(expertopinion).MayoClinic.Oct.26,2020. 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