INTRODUCTION

Infective endocarditis is an infection in the heart valves or endocardium. The endocardium is the lining of the
interior surfaces of the chambers of the heart. This condition is usually caused by bacteria entering the
bloodstream and infecting the heart. Bacteria may originate in the:

 mouth
 skin
 intestines
 respiratory system
 urinary tract

When this condition is caused by bacteria, it’s also known as bacterial endocarditis. In rare cases, it can also be
caused by fungi or other microorganisms.

Infective endocarditis is a serious condition that requires prompt medical treatment. If left untreated, the
infection can damage your heart valves. This can lead to problems including:

 stroke
 damage to other organs
 heart failure
 death

This condition is rare in people with healthy hearts. People who have other heart conditions are at higher risk.

You may need to take antibiotics before certain medical and dental procedures if you’re at high risk for
infective endocarditis. Antibiotics help stop bacteria from entering your bloodstream and causing infection.
Talk to your surgeon or dentist before any surgical procedure.

DEFINITION
 Infective endocarditis, also called bacterial endocarditis, is an infection caused by bacteria that enter
the bloodstream and settle in the heart lining, a heart valve or a blood vessel.
 Infective endocarditis is an infection in the heart valves or endocardium. 

CAUSES

This condition is usually caused by bacteria entering the bloodstream and infecting the heart. Bacteria may
originate in the:

 mouth
 skin
  intestines
 respiratory system
 urinary tract

When this condition is caused by bacteria, it’s also known as bacterial endocarditis. In rare cases, it can also be
caused by fungi or other microorganisms.

Infective endocarditis is a serious condition that requires prompt medical treatment. If left untreated, the
infection can damage your heart valves. This can lead to problems including:

 stroke
 damage to other organs
 heart failure
 death

This condition is rare in people with healthy hearts. People who have other heart conditions are at higher risk.

You may need to take antibiotics before certain medical and dental procedures if you’re at high risk for
infective endocarditis. Antibiotics help stop bacteria from entering your bloodstream and causing infection..

SYMPTOMS

Symptoms vary from person to person. In some people, symptoms come on suddenly, while others develop
symptoms more slowly. Talk to your doctor if you experience any of the symptoms listed below. People at high
risk of endocarditis should take particular care.

Symptoms may include:

 fever
 chest pain
 weakness
 blood in urine
 chills
 sweating
 red skin rash
 white spots in mouth or on tongue
 pain and swelling in joints
  muscle aches and tenderness
 abnormal urine color
 fatigue
 cough
 shortness of breath
 sore throat
 sinus congestion and headache
 nausea or vomiting
 weight loss

Infective endocarditis can be life threatening if not treated promptly. Unfortunately, signs of infective
endocarditis can resemble many other illnesses. Talk to your doctor immediately if you experience any of the
symptoms listed above.

RISK FACTORS

People may be at risk for this condition if you have:

 artificial heart valves

 congenital heart disease
 heart valve disease
 damaged heart valves
 hypertrophic cardiomyopathy
 a history of endocarditis
 history of illegal drug use
 mitral valve prolapse and valve regurgitation (leaking) and/or thickened valve leaflets

The risk of infective endocarditis is higher after procedures that allow bacteria access to the bloodstream. These
include:

 dental procedures involving the gums

 insertion of catheters or needles
 procedures to treat infections

These procedures do not put most healthy people at risk. However, people who have one or more risk factors
for infective endocarditis need to be more careful.
DIAGNOSIS

To diagnose endocarditis, a health care provider does a physical exam and asks questions about your medical
history and symptoms. Tests are done to help confirm or rule out endocarditis.

Tests

Tests used to help diagnose endocarditis include:

 Blood culture test. This test helps identify germs in the bloodstream. Results from this test help
determine the antibiotic or combination of antibiotics to use for treatment.

 Complete blood count. This test can determine if there's a lot of white blood cells, which can be a sign of
infection. A complete blood count can also help diagnose low levels of healthy red blood cells (anemia),
which can be a sign of endocarditis. Other blood tests also may be done.

 Echocardiogram. Sound waves are used to create images of the beating heart. This test shows how well
the heart's chambers and valves pump blood. It can also show the heart's structure. Your provider may use
two different types of echocardiograms to help diagnose endocarditis.

In a standard (transthoracic) echocardiogram, a wandlike device (transducer) is moved over the chest area.
The device directs sound waves at the heart and records them as they bounce back.

 Electrocardiogram (ECG or EKG). This quick and painless test measures the electrical activity of the
heart. During an ECG, sensors (electrodes) are attached to the chest and sometimes to the arms or legs. It
isn't specifically used to diagnose endocarditis, but it can show if something is affecting the heart's
electrical activity.

 Chest X-ray. A chest X-ray shows the condition of the lungs and heart. It can help determine if
endocarditis has caused heart swelling or if any infection has spread to the lungs.

 Computerized tomography (CT) scan or magnetic resonance imaging (MRI).  need scans of your
brain, chest or other parts of the body if that infection has spread to these areas.

TREATMENT

Many people with endocarditis are successfully treated with antibiotics. Sometimes, surgery may be needed to
fix or replace damaged heart valves and clean up any remaining signs of the infection.

Medications

The type of medication you receive depends on what's causing the endocarditis.
High doses of IV antibiotics are used to treat endocarditis caused by bacteria. If you receive IV antibiotics,
you'll generally spend a week or more in the hospital so that care providers can determine if the treatment is
working.

Once your fever and any severe symptoms have gone away, you might be able to leave the hospital. Some
people continue IV antibiotics with visits to a provider's office or at home with home care. Antibiotics are
usually taken for several weeks.

If endocarditis is caused by a fungal infection, antifungal medication is given. Some people need lifelong
antifungal pills to prevent endocarditis from returning.

Surgery or other procedures

Heart valve surgery may be needed to treat persistent endocarditis infections or to replace a damaged valve.
Surgery is sometimes needed to treat endocarditis that's caused by a fungal infection.

Depending on your specific condition, your health care provider may recommend heart valve repair or
replacement. Heart valve replacement uses a mechanical valve or a valve made from cow, pig or human heart
tissue (biologic tissue valve).
BIBLIOGRAPHY

1. Heart inflammation. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/heart-

inflammation. Accessed April 12, 2022.
2. Loscalzo J, et al., eds. Infective endocarditis. In: Harrison's Principles of Internal Medicine. 21st ed.
McGraw Hill; 2022. https://accessmedicine.mhmedical.com. Accessed April 12, 2022.
3. Chu VH, et al. Native valve endocarditis: Epidemiology, risk factors, and microbiology.
https://www.uptodate.com/contents/search. Accessed May 6, 2022.
4. Chu VH, et al. Clinical manifestations and evaluation of adults with suspected left-sided native valve
endocarditis. https://www.uptodate.com/contents/search. Accessed May 6, 2022.
5. Spelman D, et al. Complications and outcome of infective endocarditis.
https://www.uptodate.com/contents/search. Accessed May 6, 2022.
6. Sexton DJ, et al. Antimicrobial therapy of left-sided native valve endocarditis.
https://www.uptodate.com/contents/search. Accessed May 6, 2022.
 CLASS TEACHING
ON
INFECTIVE ENDOCARDITIS

SUBMITTED TO SUBMITTED BY
DIMPAL SAHU
MSC (N) 2ND YEAR