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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.

Risk factors

If your heart is healthy and normal, you're unlikely to develop endocarditis. The organisms that cause infection tend to adhere to and multiply in heart valves that are malformed or damaged. You're at risk of endocarditis if you have:

  • Heart valves damaged by conditions such as rheumatic fever. Certain medical conditions such as rheumatic fever — a once-common childhood illness — can damage or scar one or more of your heart valves, making them more prone to infection than is a normal valve.

  • Congenital heart or heart valve defects. If you were born with an abnormal heart valve or other heart defect, your heart may be more susceptible to infection than a healthy heart is.

  • Other heart valve problems. Severe mitral valve prolapse is the most common heart condition associated with endocarditis. In this condition, your mitral valve — one of the four heart valves that normally open and close to allow blood to flow in only one direction through your heart — doesn't close properly. In severe cases, the valve may even allow blood to flow backward in your heart. This condition, like other valve problems, can put you at risk of endocarditis.

  • Artificial heart valve. An artificial heart valve can be a spot for bacteria to settle and multiply, infecting the surrounding tissue. Bacteria can also be introduced into your heart during surgery to implant an artificial valve. If you've had surgery to replace a damaged heart valve with an artificial heart valve of any type, you're at risk of endocarditis.

  • Thickening of the heart muscle (hypertrophic cardiomyopathy). This rare condition impedes blood flow through the heart. It can damage or distort heart valves, causing a higher risk of endocarditis. Symptoms include shortness of breath, chest pain and loss of consciousness with exertion.

  • History of previous endocarditis. Endocarditis almost always further injures your heart, putting you at increased risk of a future heart infection.

If you have a known heart defect or heart valve problem, ask your doctor about your chances of developing endocarditis. Even if your heart condition hasn't caused symptoms or it has been repaired and you are healthy, you may still be at risk.

Just remember that most types of heart disease don't raise your risk of endocarditis. Having a cardiac pacemaker or an implanted defibrillator doesn't necessarily put you at risk of endocarditis. Neither does a heart attack or coronary artery disease — a narrowing of the arteries that feed the heart.

However, some people without heart problems are at risk of endocarditis. Intravenous (IV) drug users have a greater risk of infection because sharing or reusing needles can expose the bloodstream to infectious agents. People who are hospitalized with IV tubes also may be exposed to infection.

 Endocarditis > 1 > 2 > 3 > 4

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