Endocarditis

Endocarditis is an infection of the inner lining of your heart and occurs when bacteria or other germs from another part of your body spread through your bloodstream and attach to damaged areas in your heart. Left untreated, endocarditis can damage or destroy your heart valves and can lead to life-threatening complications. Treatments for endocarditis include antibiotics and, in certain cases, surgery.

If you or a loved one has been diagnosed with endocarditis that requires surgical intervention, our expert cardiothoracic surgeons at the Fred and Lena Meijer Heart Center will work closely with referring physicians and other specialists to develop a comprehensive treatment plan.

Treatments for Endocarditis

Antibiotics can treat endocarditis in most cases. You may also need heart surgery to repair or replace heart valves or remove infected heart tissue. A cornerstone of Spectrum Health’s heart and vascular care is cardiothoracic surgery. Our team of expert surgeons at the Fred and Lena Meijer Heart Center provide sophisticated techniques and unique lifesaving surgical solutions to deliver an outstanding patient experience.

Medication Management
Along with very important lifestyle changes, there are a variety of medicines used to help treat heart conditions. Medicines for heart disease are used to ease discomfort or lessen symptoms, but some can also be essential in preventing life-threatening episodes. It is important to take your medicines exactly as prescribed, and work with your doctor on both lifestyle and medicine changes.

Surgical Valve Repair or Replacement
During this procedure a surgeon can repair or replace the mitral valve. This is generally performed as an endoscopic surgery with the assistance of a guided camera and precise tools.

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What Is Endocarditis?

Endocarditis is inflammation, with or without infection, that affects the inside lining of the heart and heart valves.

What Causes Endocarditis?

Bacteria or fungi are the usual cause. Bacteria include Staphylococcus and Streptococcus. The bacteria or fungi can get to the heart by entering the bloodstream from infections somewhere else in the body (e.g., urinary or gastrointestinal tract or skin). Surgical or dental procedures can also let these organisms reach the heart.

What Are the Symptoms of Endocarditis?

Symptoms include fever, fatigue, weakness, chills and night sweats, muscle and joint pain, and heart murmur. Later symptoms are swelling of feet and legs and shortness of breath with an irregular heartbeat.

How Is Endocarditis Diagnosed?

The health care provider can make a diagnosis by taking a medical history, doing a physical examination, and getting blood cultures and an echocardiogram (ultrasound of the heart). The health care provider usually finds a new heart murmur due to the damaged heart valve at the physical.

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How Is Endocarditis Treated?

Intravenous antibiotics, usually given for 4 to 6 weeks, are used to get rid of the infection. A home health nurse will help with intravenous antibiotic treatment at home. Nonaspirin medications such as acetaminophen can be used for fever and minor pain. A regular diet can be followed. Fluid intake should be increased for fever. Good dental hygiene is needed to prevent infection.

Another goal is to treat complications (e.g., congestive heart failure or blood clots). The health care provider may suggest surgery in some cases. Surgery may be needed for congestive heart failure that doesn’t respond to usual therapy, endocarditis caused by fungi, recurrent blood clots, abscesses leading to heart rhythm abnormalities, and lasting high fever or sepsis after 72 hours of antibiotics.

DOs and DON’Ts in Managing Endocarditis:
  • DO take your antibiotics until they’re gone. Endocarditis may be prevented by using antibiotics before dental procedures if you have a history of prior infectious endocarditis, heart transplant, certain congenital heart diseases, or prosthetic valves.
  • DO use nonaspirin drugs for fever and minor pain.
  • DO increase fluid intake, especially during fever.
  • DO resume normal activity slowly as your strength allows.
  • DO see your dentist regularly. Use a soft-bristled toothbrush.
  • DO call your health care provider if, after your treatment, you have fever, loss of appetite or weight gain without diet changes, blood in your urine, chest pain, shortness of breath, or sudden weakness in muscles of your face or limbs.
  • DON’T skip doses or stop taking antibiotics until you finish a complete treatment course, or until your health care provider tells you to stop.
  • DON’T try to keep your normal schedule; you need rest for a full recovery.
  • DON’T have dental work or surgical procedures without telling your health care provider of your history of endocarditis.
FOR MORE INFORMATION

Contact the following sources:

  • National Heart, Lung, and Blood Institute
    Tel: (301) 592-8573
    Website: http://www.nhlbi.nih.gov

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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