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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.

When to seek medical advice

Other less serious conditions can cause signs and symptoms similar to those of endocarditis. But you won't know what's causing your symptoms until you see a doctor. If you develop indicators of endocarditis, see your doctor right away, especially if you've been told that you're at risk of this serious infection.

Screening and diagnosis

Your doctor may suspect endocarditis based on your medical history and a physical exam. During a physical exam, your doctor may uncover signs of endocarditis such as fever. Using a stethoscope to listen to your heart, your doctor may hear a new heart murmur or a change in a previous heart murmur — possible indicators of endocarditis.

The infection can mimic other illnesses in its early stages. But doctors can usually arrive at the right diagnosis with the help of these tests:

  • Blood tests. Your doctor may take several samples of your blood for testing. Blood tests can help determine whether you have markers of an infection, including anemia — a shortage of healthy red blood cells that can be a sign of endocarditis. Your blood may also be cultured to help your doctor identify the type of bacteria or other microorganism that may be infecting your heart so that you can take the right antibiotic to fight it.

  • Echocardiogram. This test uses sound waves to produce images of your heart at work. It helps your doctor check for abnormalities in your heart valves or chambers. It may show abnormal thickening or leakage of heart valves, or even abnormal growths (vegetations) that contain collections of bacteria, a telltale sign of endocarditis.

  • Transesophageal echocardiogram. This type of echocardiogram allows your doctor to get a closer look at your heart valves, to check for vegetations or infected tissue (abscesses). It requires an ultrasound device to be passed through your mouth and into your esophagus — the tube that connects your mouth and stomach. Because your esophagus lies close to your heart, this test produces very clear images of your inner heart.

  • Electrocardiogram (ECG). In this test, patches with wires (electrodes) are attached to your skin to measure the electrical impulses given off by your heart. Impulses are recorded as "waves" displayed on a monitor or printed on paper. An infection in the heart can cause disruptions in the normal flow of electrical rhythms through your heart that may be apparent on an ECG.

  • Chest X-ray. An X-ray image of your chest allows your doctor to check your heart and lungs, looking for physical abnormalities. If you have endocarditis, an X-ray may reveal blood and fluid backed up into your lungs because the condition can make it harder for your heart to pump blood normally.


If not discovered and adequately treated, endocarditis can permanently destroy your heart's inner lining and damage your heart valves. This can cause your heart muscle to work harder to pump blood, and it may become weak, leading to heart failure — a chronic condition in which your heart is unable to pump enough blood to meet your body's needs.

A more common danger with endocarditis is that clumps of bacteria and cellular debris (vegetations) may form in your heart at the site of the infection. These clumps can break loose and travel to your brain, lungs or abdomen, causing a variety of problems, including stroke, neurologic changes or organ damage.

If endocarditis goes untreated and the infection progresses, it's usually fatal.

 Endocarditis > 1 > 2 > 3 > 4

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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.
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Last Modified : 03/15/08 12:28 AM