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What is endocarditis?

Endocarditis is an infection of the inner lining of your heart. It may also affect the valves of your heart. Endocarditis, and the health problems it may cause, can be serious and can become life-threatening.

What causes endocarditis?

Endocarditis is most often caused by a bacterial infection. It may also be caused by viral, fungal, or parasitic infections. Some autoimmune disease, such as rheumatoid arthritis and cancer, can increase your risk for endocarditis. Bacteria or other germs may enter your bloodstream and get to your heart in the following ways:

  • Surgery or medical procedures
  • Dental procedures
  • Urinary or IV catheters
  • Skin, mouth, or intestinal sores
  • Injecting illegal drugs

What are the signs and symptoms of endocarditis?

  • Fever
  • Cough or shortness of breath
  • Small red spots in your eye
  • Headaches, body aches, or joint pain
  • A fast or pounding heartbeat, or heart flutters
  • Swelling in your legs, feet, or ankles
  • Chest pain

How is endocarditis diagnosed?

Your caregiver will examine you and ask about your symptoms. He will ask if you have other medical conditions or take any medicines. You may need any of the following:

  • Blood and urine tests may show if you have an infection or if another health condition is causing your symptoms.
  • An EKG records your heart rhythm and how fast your heart beats. It is used to check for damage to your heart.
  • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart.
  • An x-ray, CT scan, or MRI scan may be used. You may be given contrast dye before a CT or MRI scan to help caregivers see your heart better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.

How is endocarditis treated?

Treatment depends on the cause your endocarditis, and the symptoms you have. You may need any of the following:

  • Medicines may be given to treat a bacterial infection. You may need other medicine to strengthen your heart, decrease blood pressure, or to remove extra body fluid.
  • Blood thinners help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising while you take blood thinners. 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 to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
    • Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin.
      • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
  • Surgery is done to repair or replace a damaged heart valve.

How can I manage my symptoms?

  • Adjust your activities as directed. You may need to decrease your activities or exercise while you have symptoms. Ask your caregiver about the best exercise plan for you.
  • Eat heart healthy foods. Foods that help protect the heart include fruits, vegetables, nuts, salmon, and canola and soybean oils. You may be told to eat foods low in cholesterol or sodium (salt) or high in fiber. You may also be told to limit saturated and trans fats. Ask for more information about a heart healthy diet.
  • Maintain a healthy weight. Ask your caregiver how much you should weigh. Ask him to help you create a weight loss plan if you are overweight.
  • Do not smoke. If you smoke, it is never too late to quit. Ask for information if you need help quitting.

How can I help prevent endocarditis?

  • Keep your teeth and gums healthy. Brush your teeth 2 to 3 times every day. It is best to brush your teeth after meals. Gently brush your teeth and gums with a clean toothbrush that has soft bristles. See your dentist for regular checkups. Always tell your dental caregivers that you have had endocarditis.
  • Ask your caregiver if you should take antibiotics before certain procedures. Some procedures may allow bacteria to get into your blood and travel to your heart. You may need medicine to prevent a bacterial infection.

When should I contact my caregiver?

  • You have a fever.
  • You lose your appetite or are unable to eat.
  • You have increased fatigue and weakness.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or returns
    • Discomfort or pain in your back, neck, jaw, stomach, or arm
    • Trouble breathing
    • Nausea or vomiting
    • Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing
  • You have any of the following signs of a stroke:
    • Numbness or drooping on one side of your face
    • Weakness in an arm or leg
    • Confusion or difficulty speaking
    • Dizziness, a severe headache, or vision loss
  • You have sudden trouble breathing or shortness of breath while lying down.
  • Your heart pounds or flutters, or your heart rate is faster than normal for you.
  • You have new or increased swelling in your feet or ankles.
  • You feel faint.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.