• Heart Disease

Endocarditis: Causes, Symptoms, and Treatment Options

Medically reviewed and edited by Holly Lunsford, APRN, FNP

Endocarditis is a rare heart condition that affects over 47,000 Americans every year.

Undiagnosed endocarditis can be fatal, so it’s important to know the causes and risk factors associated with this condition.

Understanding these factors can help you determine when you need to consult your doctor.

In this article, we’ll take a closer look at the various causes of endocarditis, symptoms to watch for, and what you might expect from your treatment plan to help you effectively manage this condition.

What is Endocarditis?

Endocarditis is a serious condition that develops when the inner lining of the heart — called the endocardium — becomes inflamed.

If left untreated, endocarditis can cause significant damage to the heart valves, which can have life-threatening consequences.

It’s important to note that there are two main types of endocarditis that affect the heart in different ways. These types are:

• Infective endocarditis (IE): This is the most common type of endocarditis and it develops when bacteria, fungi, or other microorganisms spread through the bloodstream and damage the heart.

• Noninfective endocarditis: Although less common, noninfective endocarditis may develop due to autoimmune disorders, cancer, or the use of certain medications.

Symptoms of endocarditis

The symptoms of endocarditis can differ widely among individuals, depending on the cause and severity of the condition. Symptoms may either develop over time or appear suddenly.

Individuals with endocarditis typically experience the following:

• Fever and chills

• Spots on the skin, fingernails, or whites of the eyes

• Painful nodes on the fingers or feet

• Tender spots on the palms or soles of the feet

• Fatigue and weakness

• Aching joints or muscles

• Shortness of breath

• Swelling of the legs, abdomen, or feet

• Night sweats

• Unexplained weight loss

• Blood in the urine

What are the Causes of Endocarditis?

Various factors can cause endocarditis to develop, including:

• Bacterial infections: The most common cause of endocarditis is a bacterial infection caused by the Staphylococcus aureus, Streptococci, and Enterococci organisms. Bacteria may enter the bloodstream during certain medical procedures, dental procedures, or recreational drug use.

• Fungal infections: Fungal endocarditis is less common but more severe and is often caused by Candida or Aspergillus bacteria. This infection is more likely to occur in people with compromised immune systems — such as those with HIV/AIDS or cancer — or in those who have had organ transplants.

• Noninfectious causes: Noninfective endocarditis can be caused by certain conditions that lead to inflammation — such as autoimmune diseases like lupus, and cancer — or the use of certain medications.

• Heart conditions and structural defects: Damaged or abnormal heart tissue caused by structural defects can become a breeding ground for microorganisms, which may cause inflammation that leads to endocarditis.

Endocarditis Risk Factors

Certain factors may increase your chances of developing endocarditis, such as:

• Existing heart conditions: Individuals with congenital heart defects (or congenital heart disease), artificial heart valves, a history of endocarditis, or previously damaged heart valves have an elevated risk of developing the condition.

• History of heart surgery: People who have undergone artificial heart valve surgery or had a heart transplant are more likely to develop endocarditis.

• Intravenous (IV) drug use: Using IV drugs — especially with unsterile needles — can introduce bacteria directly into the bloodstream, increasing the risk of endocarditis.

• Chronic hemodialysis: Patients undergoing long-term dialysis are at risk due to the repeated need to access the bloodstream with needles, which can introduce bacteria.

• Dental procedures and poor oral health: Poor dental health and certain invasive dental procedures can increase the risk of bacteria entering the bloodstream, causing bacterial endocarditis.

• Implanted medical devices: Certain implanted medical devices — like pacemakers or defibrillators — can increase the risk of bacterial attachment and infection.

• Certain medical conditions: Conditions that weaken the immune system — like HIV/AIDS, diabetes, or cancer — can make a person more susceptible to infections like endocarditis.

• Age and gender: Older adults — often due to heart valve wear and other health issues — and men, are at a somewhat increased risk for endocarditis.

• Other invasive procedures: Procedures involving the gastrointestinal tract, urinary, or respiratory system can also pose a risk.

How is Endocarditis Diagnosed?

Endocarditis should be diagnosed by a medical professional, who will use a combination of physical assessments, laboratory tests, and imaging.

During a physical assessment, your doctor will ask you about your symptoms and medical history, while also checking for physical indicators such as heart murmurs.

After this assessment, blood tests may be ordered. These tests are crucial for identifying bacteria and other organisms causing the infection.

Your doctor may also recommend an imaging test called a transesophageal echocardiogram (TEE), which provides detailed images of the heart's structure.

This test can reveal heart valve or chamber abnormalities that may indicate endocarditis.

In higher-risk endocarditis cases, CT scans or MRIs may be utilized to check for complications.

What are the Treatment Options for Endocarditis?

Antibiotic therapy

The first-line treatment for infectious cases of endocarditis is a prolonged course of antibiotics that is often administered intravenously (directly into the vein).

Your doctor will recommend specific antibiotics depending on the bacteria causing the infection to ensure that the medication is effective.

The antibiotics course is typically administered for 4 to 6 weeks. It’s essential to complete the antibiotic course — even if you start to feel better — to avoid antibiotic resistance.

Anti-inflammatory medications

If your endocarditis is caused by noninfectious factors — like autoimmune diseases — your doctor may recommend using anti-inflammatory medications to help you manage your symptoms.

These medications can reduce inflammation and swelling in the heart and may include:

• Corticosteroids

• Nonsteroidal anti-inflammatory drugs (NSAIDs)

In certain cases, anti-inflammatory, immunosuppressive drugs may be prescribed, but this will depend on the underlying cause of your condition.

Remember, while these medications can manage symptoms and inflammation, they may not directly address the root cause of noninfectious endocarditis.

These causes will be addressed as part of a broader treatment plan, which will be managed by your healthcare provider.

Surgery

In cases where endocarditis has caused significant damage to the heart valves, your doctor will likely recommend surgical procedures to treat your condition.

These procedures typically involve repairing the damaged heart valves or replacing them with prosthetics.

Whether the valves need replacing or repairing depends on the extent of the damage, the type of infection, and your overall health.

Can Endocarditis Be Cured?

Curing endocarditis largely depends on the type you develop, how early it’s diagnosed, and the effectiveness of your treatment.

If detected early, most cases of infective and noninfective endocarditis can be cured with a proper treatment plan. This also helps to avoid further complications which can cause life-long issues.

Once you’ve completed your treatment, it’s essential to take preventative steps to avoid recurring endocarditis.

This generally includes leading a healthy lifestyle and taking any necessary medications as prescribed by your doctor.

Regular checkups are important to monitor your health and detect abnormalities early on for effective treatment.

Should You See a Doctor About Endocarditis?

Endocarditis is a serious condition that can have life-threatening complications if left untreated.

If you suspect that you might have endocarditis, speak to your doctor as soon as possible.

You should also see a doctor if you experience symptoms such as:

• Unexplained fever

• Persistent fatigue

• New or changed heart murmurs

• Unexplained weight loss

• Signs of blood infection

• Signs of blood flow issues, such as abnormal swelling in the lower body

If you're in a high-risk group for endocarditis and experience symptoms, prompt medical consultation is crucial.

Timely detection and treatment are key to preventing severe complications and improving your overall well-being.

Where Can You Learn More about Endocarditis and Other Conditions?

If you’re concerned about your symptoms or want to know more about endocarditis, LifeMD is here to help.

We can connect you to a team of medical professionals who can provide information and guidance on managing your condition while avoiding further complications.

Make an appointment today to get started.

Holly Lunsford, APRN, FNP

Holly is an Advanced Practice Nurse Practitioner with more than 10 years of experience. She earned her Master’s of Science with a Family Nurse Practitioner concentration from the University of Memphis. Her extensive healthcare expertise spans across Emergency Medicine, Urgent Care, and Obesity Treatment. Holly is married and is a mom of three boys. In her free time, she enjoys making memories at the lake and traveling. She loves entertaining family and friends in her home – and she also has a passion for interior and graphic design.

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