Infective Endocarditis

ExitCare ImageInfective endocarditis is an infection of the inner layer of heart (endocardium) or the heart valves. An endocarditis infection is caused by many things, including viruses, bacteria, or fungi that enter your bloodstream. If left untreated, endocarditis can cause other problems, which may include:

  • Heart valve damage.

  • Blood clots (embolism).

  • Irregular heartbeat (arrhythmia).

  • Heart failure.


Surgery, dental work, and intravenous (IV) drug abuse can allow bacteria or fungi to enter the bloodstream. Once in the bloodstream, bacteria can attach to the inner lining of the heart or heart valves, causing infection.


  • Fever and chills.

  • Skin rashes.

  • Heart murmurs.

  • Spleen enlargement.

  • Unexplained weight loss.

  • Shortness of breath.

  • Blood in urine.

  • Lethargy and fatigue.

  • Sudden weakness in face, arms, legs (possible stroke).

  • Night sweats.


  • Endocarditis may be suspected if your caregiver hears a heart murmur, observes certain skin rashes, or there are changes in your eye exam.

  • Tests include:

  • Blood work.

  • Transthoracic echocardiogram (TTE). A TTE uses sound waves to produce images of the heart. A hand-held device is placed on the chest and transmits sound waves. These sound waves bounce off the heart to produce images that help your caregiver detect heart damage.

  • Transesophageal echocardiogram (TEE). For a TEE, a flexible tube is passed down your throat and into the esophagus. Because the esophagus is close to the heart, a TEE allows different images of the heart to be obtained. This type of procedure requires sedation.


  • Those with a history of endocarditis.

  • People with artificial (prosthetic) heart valves.

  • Cardiac transplant patients with valve disease.

  • People with congenital heart disease, including:

  • Those with unrepaired congenital heart defects.

  • Those with a congenital heart defect repaired with prosthetic materials. Within the first 6 months of the procedure, you are still at risk for infection. After 6 months, talk to your caregiver about your special needs.

  • Those who have had surgery to correct the defect but with some remaining problems at the site of repair.


If you are at the highest risk for infective endocarditis, you may need to take antibiotics before having dental work or other surgical procedures. These medicines help to prevent infective endocarditis. Let your dentist and your caregiver know if you have a history of any of the following so that the necessary precautions can be taken:

  • A ventricular septal defect (VSD).

  • A repaired VSD.

  • Endocarditis in the past.

  • A prosthetic heart valve.


  • IV antibiotic treatment may be needed for several weeks to treat endocarditis.

  • Surgery may be needed to remove the infected tissue in the heart.

  • Surgery to repair valve damage.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.