Endocarditis is an inflammation of the inside lining (endocardium) of the heart chambers and heart valves. This infection can lead to heart valve damage or other serious complications.
Endocarditis can produce a number of symptoms, which can develop gradually or suddenly. These include:
- Fatigue and weakness
- Fever, chills or night sweats
- Irregular heart beat
- Joint pain
- Paleness
- Shortness of breath
Risk factors include intravenous (IV) drug use, previous valve surgery and recent dental surgery. Endocarditis is usually caused by a bacterial infection, but may also develop from fungal or unknown infections.
Endocarditis can be indicated by the patient's medical history - specifically pertaining to known risk factors, such as congenital heart disease, IV drug use, recent dental surgery and rheumatic fever. A physical examination may reveal other indicators, such as abnormal fingernail growth or bleeding, a heart murmur, retinal hemorrhaging or spleen enlargement. To confirm a diagnosis, the following tests could be performed:
- Blood culture laboratory tests can detect bacteria and fungi in the blood
- Chest X-ray
- Computed tomography (CT) scans use X-rays to create slice images of the heart that can be compiled into a complete three-dimensional image
- Echocardiography uses soundwaves to create a moving image of the heart
- Transesophageal echocardiography
- Ventilation/perfusion (V/Q) scans are nuclear medicine procedures for evaluating circulation
Early diagnosis and treatment of endocarditis is key to a successful outcome. Administering IV antibiotics is usually the first step in treatment. Long-term drug therapy with bacteria-specific antibiotics is necessary to completely eradicate the infection. If the disease causes heart valve damage, surgery may be needed to replace the affected heart valve.
