Infective Endocarditis

WHAT YOU SHOULD KNOW:

• The endocardium is a thin layer of tissue that lines the inside of your heart. It covers the walls of your heart chambers (rooms), and your heart valves. Your heart valves act as one-way doors to direct the flow of blood through the heart. Infective endocarditis occurs when this lining becomes infected. The infection causes inflammation of the endocardium. Bacteria are the germs that most commonly cause infective endocarditis. Bacteria get into your body in different ways, such as during surgery, dental care, or injecting street drugs. Health problems, such as heart and immune system problems, may increase your risk of endocarditis.
  
  
• With endocarditis, you may feel weak, have a fever, feel tired, or have body soreness. With a more serious case of endocarditis, you may be very sick and unable to care for yourself. You may need to stay in the hospital for tests and treatment. Tests you may need include lab tests, x-rays and scans, and other heart and lung tests. Medicines for your heart, blood pressure, and infection may help you get better. You may need other treatments, depending on the problems your endocarditis has caused.

INSTRUCTIONS:

Medicines:

• Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
  
  
• Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.
  
  
• If a medicine makes you drowsy: Some medicines may make you drowsy (tired) or less able to think clearly. Avoid driving, signing legal papers, operating heavy equipment or other activities that you must be alert to do. Never drink alcohol while you are taking medicines that make you feel drowsy or less alert.
  
  
• Information about common medicines: Your caregiver may suggest one or more of the following medicines.
  
  
  • Antibiotics:
    
    
    • This medicine is given to fight or prevent infection caused by bacteria. Always take your antibiotics exactly as ordered by your caregiver. Keep taking this medicine until it is completely gone, even if you feel better. Stopping antibiotics without your caregiver's OK may make the medicine unable to kill all of the germs. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
      
      
    • You may need antibiotic medicine through an IV, even after you go home. Caregivers will teach you and your family how to give the antibiotics. A home care nurse may come to your home to teach you how to put the medicine in the IV. You may need antibiotics and blood tests for several weeks.
    
    
  • Blood thinners: Blood thinners are medicines that help prevent blood clots from forming. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for you to bleed or bruise. If you are taking a blood thinner:
    
    
    • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin and a soft toothbrush on your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports, such as football.
      
      
    • Be aware of what medicines you take. Many medicines cannot be used when taking medicine to thin your blood. Tell your dentist and other caregivers that you take blood-thinning medicine. Wear or carry medical alert information that says you are taking this medicine.
      
      
    • Take this medicine exactly as your primary healthcare provider tells you. Tell him right away if you forget to take the medicine, or if you take too much. You may need to have regular blood tests while on this medicine. Your primary healthcare provider uses these tests to decide how much medicine is right for you.
      
      
    • Talk to your primary healthcare provider about your diet. This medicine works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and other foods, such as cooked peas and kiwifruit.
    
    
  • Aspirin: You may need to take an aspirin a day to help prevent heart problems. Aspirin helps to prevent blood clots from forming and causing blood flow problems in the heart. If caregivers want you to take aspirin daily, do not take acetaminophen or ibuprofen instead. Do not take more or less aspirin than caregivers say to take. If you are on other blood thinner medicine, ask your caregiver before you take aspirin for any reason.
    
    
  • Blood pressure medicine: This is given to lower your blood pressure. A controlled blood pressure helps protect your organs, such as your heart, lungs, brain, and kidneys. Take your blood pressure medicine exactly as directed.
    
    
  • Diuretics: This medicine is given to decrease edema (excess fluid) that collects in a part of your body, such as your legs. Diuretics can also remove excess fluid from around your heart or lungs and decrease your blood pressure. It is often called water pills. You may urinate more often when you take this medicine.
    
    
  • Heart medicine: This medicine is given to strengthen or regulate your heartbeat. It also may help your heart in other ways. Talk with your caregiver to find out what your heart medicine is and why you are taking it.
    
    
  • Pain medicine: You may need medicine to take away or decrease pain.
    
    
    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
      
      
    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Preventing infective endocarditis:

Having certain heart problems increases your risk of getting infective endocarditis. Having had endocarditis in the past increases your risk of getting it again. The following may help decrease your risk of having infective endocarditis again:

• Keep your teeth and gums healthy. Brush your teeth two to three times every day. It is best to do this after meals. Gently brush your teeth and gums using a clean toothbrush with soft bristles. See your dentist for regular checkups. Always tell your dental caregivers that you had endocarditis in the past.
  
  
• Ask your caregiver if you should take antibiotics before certain procedures. Some procedures may allow germs to get into your blood and travel to your heart. You may need to take antibiotic medicine before certain dental and medical procedures to prevent this. Tell caregivers about heart problems and surgeries you have had in the past.

Activity and home care:

• Good nutrition for your heart: Get enough calories, protein, vitamins, and minerals to help prevent poor nutrition and muscle wasting. You may be told to eat foods low in cholesterol or sodium (salt). You also may be told to limit saturated and trans fats. Do eat foods that contain healthy fats, such as walnuts, salmon, and canola and soybean oils. Eat foods that help protect the heart, including plenty of fruits and vegetables, nuts, and sources of fiber. Ask what a healthy weight is for you. Set goals to reach and stay at that weight.
  
  
• Other illnesses: If you have other illnesses like diabetes or lung problems, you need to control them. Take your medicines as directed by your caregiver.
  
  
• Exercise: For awhile, you may have to decrease your activities and not do any hard exercise. Talk to your caregiver before you start exercising. Together you can plan the best exercise program for you. It is best to start slowly and do more as you get stronger. Exercising makes the heart stronger, lowers blood pressure, and keeps you healthy.
  
  
• Do not smoke: If you smoke, it is never too late to quit. Ask for information about how to stop smoking if you need help.

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• You are unable to eat, or do not want to eat.
  
  
• You become more tired or weak than before.
  
  
• Your skin is itchy, swollen, or has a rash after you have started using a new kind of medicine.
  
  
• You have questions or concerns about your illness or medicine.

SEEK CARE IMMEDIATELY IF:

• You have new or worsening swelling in your feet or ankles.
  
  
• You have trouble breathing all of a sudden, or have shortness of breath while lying down.
  
  
• You faint (pass out) or feel like fainting.
  
  
• You feel that your heartbeat is not regular, is too fast, or is too slow.
  
  
• If you have any of the following signs and symptoms, it is an emergency! Call 911 or 0 (operator) to get to the nearest hospital or clinic. Do not drive yourself!
  
  
  • Signs and symptoms of a possible heart attack:
    
    
    • Chest pain, tightness, or discomfort that spreads to your arms, jaw, neck, shoulders, or back.
      
      
    • Unusual, sudden back pain.
      
      
    • Nausea (sick to your stomach).
      
      
    • Shortness of breath.
      
      
    • Sweating for no reason that you know of. Your skin or nail beds may become pale.
    
    
  • Signs and symptoms of a possible stroke (brain attack): The following symptoms may happen suddenly.
    
    
    • A very bad headache. This may feel like the worst headache of your life.
      
      
    • Too dizzy to stand.
      
      
    • Weakness or numbness in your arm, leg, or face. This may happen on only one side of your body.
      
      
    • New or worsening confusion, or problems with speaking or understanding things.
      
      
    • Not able to see out of one or both of your eyes, and this is new for you.

Learn more about Infective Endocarditis (Aftercare Instructions)