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20 / 04 / 2018
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Heart Disease


Endocarditis is a relatively uncommon but potentially dangerous type of carditis (heart inflammation), usually caused by heart infection in vulnerable areas. The heart is a pump about the size of your fist. The wall of your heart consists of a thick layer of muscle wrapped in a thin membrane called the pericardium. The inside of your heart consists of four chambers and four valves lined by a thin membrane called the endocardium. Endocarditis is an infection of this inner lining.

Typically, endocarditis involves one of your heart valves and occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and lodge in your heart. Left untreated, endocarditis can damage or destroy your heart valves, and it can be fatal.

Signs and symptoms

Endocarditis may develop slowly, or it may occur suddenly. The speed at which signs and symptoms develop depends partly on the type of microorganism causing the infection and on whether you have underlying heart abnormalities. Signs and symptoms may include:

  • Fatigue

  • Fever

  • Anemia — a shortage of red blood cells, which carry oxygen to your tissues

  • A new heart murmur

  • Weakness

  • Chills

  • Aching joints and muscles

  • Night sweats

  • Cough

  • Shortness of breath

  • Swelling in your legs, ankles or feet

  • Loss of appetite

  • Unexplained weight loss

  • Blood in your urine

  • Headache

  • Tenderness in your spleen — an abdominal organ on your left side, just below your rib cage

Endocarditis can also cause red, tender spots known as Osler's nodes underneath the skin of your fingers. Or it may cause red spots that aren't tender called Janeway lesions. These spots develop on the palms of your hands and the soles of your feet. Some people with endocarditis develop other types of skin rashes, such as tiny, purple or red spots known as petechiae on other areas of the skin. Similar spots may appear in the whites of your eyes or under your fingernails. Such spots — wherever they appear on your body — are the result of tiny broken blood vessels that can occur with endocarditis.


Endocarditis occurs when germs enter your bloodstream, travel to your heart and lodge on abnormal heart valves or damaged heart tissue. The condition is also called infective or infectious endocarditis and can be caused by any microorganism, including fungi and viruses. However, most cases are caused by bacteria and may be referred to as bacterial endocarditis.

The culprit may be one of many common bacteria that live on other parts of your body, such as in your mouth or upper respiratory tract. Or the offending organism may come from outside your body. In either case, the presence of bacteria in your bloodstream is called bacteremia. Sources of bacteremia include:

  • Dental or surgical procedures. Bacteria can gain entry to your bloodstream during certain dental or medical procedures that introduce germs from the outside or release your own germs into your bloodstream. Bacteria can also enter your bloodstream after invasive procedures. For example, bacteria from your intestinal tract may enter your bloodstream during an examination or surgical procedure involving the prostate, bladder, rectum or female pelvic organs. In rare cases, bacteria can enter the heart directly during heart surgery or enter the bloodstream during childbirth.

  • An infection or other medical condition. Bacteria may spread from a localized infection, such as an infected sore on your skin. Or they can get into your bloodstream as a result of another medical condition, such as gum disease, a sexually transmitted disease or an intestinal disorder, such as inflammatory bowel disease.

  • Catheters or needles. In people who use intravenous drugs, bacteria can enter the bloodstream through contaminated needles and syringes. Bacteria can also enter your body through a catheter — a thin tube that doctors sometimes insert into an opening in your body as part of medical treatment.

  • Common activities. Even everyday activities such as brushing your teeth or chewing food can allow bacteria to enter your bloodstream — especially if your teeth and gums are in poor condition.

Endocarditis isn't common because bacteria can infect the heart only under certain conditions. Usually, your immune system destroys bacteria that make it into your bloodstream, so it's rare for bacteria to reach your heart. In addition, bacteria may pass through a normal heart and never cause an infection. Most people who develop endocarditis have a diseased or damaged heart valve — an ideal spot for bacteria to settle. This damaged tissue in the endocardium provides bacteria with the roughened surface they need to attach and multiply.

Endocarditis occurs when germs enter your bloodstream, travel to your heart, and lodge on abnormal heart valves or damaged heart tissue.  

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.

In no event will the be liable for any decision made or action taken in reliance upon the information provided through this web site.
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