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Endocarditis
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Endocarditis

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HEART & BLOOD

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.

Prevention

If you're at risk of endocarditis, you may need to take antibiotics before undergoing certain medical or dental procedures that may allow bacteria to enter your bloodstream, travel to your heart and cause an infection. Antibiotics reduce the risk of endocarditis by destroying or controlling harmful bacteria.

In general, if a procedure causes bleeding, it may require the use of antibiotics beforehand. Antibiotics may be needed in these circumstances:

  • Dental procedures and oral or respiratory tract surgery. Before you undergo any procedure on your mouth or throat that may cause bleeding — including a routine cleaning at the dentist's office — your doctor or dentist may prescribe a type of penicillin called amoxicillin (Amoxil, Trimox) to be taken orally one hour before the procedure. If you're allergic to penicillin, you can take another antibiotic such as clindamycin (Cleocin) or azithromycin (Zithromax) or a cephalosporin antibiotic such as cephalexin (Keflex). If you're at high risk of endocarditis, your physician may prescribe a faster-acting injectable antibiotic. 

  • Urologic procedures, gastrointestinal surgery or examination with instruments. You'll likely need antibiotics before urologic procedures such as bladder operations, transurethral resection of the prostate (TURP) and gynecologic procedures, not including routine pelvic exams or Pap smears. Gastrointestinal procedures such as hemorrhoid removal, polyp removal and surgery to your colon are another cause for antibiotics. If your risk of endocarditis is high, your doctor may recommend taking injectable antibiotics just before these procedures and again eight hours afterward. People at lower risk may only need oral antibiotics before these procedures.

  • Lung and skin infections. If you develop a lung or skin infection — or any other type of infection — your doctor may prescribe antibiotic treatment to prevent endocarditis.

It may also be wise to take antibiotics before other nonmedical procedures — even ear piercing and body tattooing. Talk to your doctor before scheduling any procedure to determine if you need antibiotics, and carefully follow the prescription instructions.

Self-care

If you're at risk of endocarditis, let all of your health care providers know. Many people carry a card prepared by the American Heart Association for this purpose. You can obtain one through your local chapter or by visiting the association's Web site.

You can also help prevent endocarditis by taking good care of yourself and avoiding infections. In particular, take care of your teeth and gums, because your mouth can be a reservoir for germs. Tooth decay and gum disease are caused by an overgrowth of bacteria in your mouth. Many cases of endocarditis follow nothing more than a minor gum injury or are caused by poor dental hygiene.

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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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