Endocarditis

Need The Area’s Advanced Endocarditis Treatment? Orange County Trusts Hoag for Cardiac Care.

At Hoag’s Jeffrey M. Carlton Heart & Vascular Institute, we pride ourselves on being at the forefront of cardiovascular care, harnessing leading-edge technology to provide unparalleled treatment options for a range of cardiac conditions through our Heart Failure Program, including endocarditis.

Our commitment to innovation and providing the best patient care is evident in our state-of-the-art facilities and equipment. That world-class technology is complemented by a unique, patient-focused approach to heart failure care by a world-class team of experts. Contact us today through our online form or by calling 949-764-5384.

Read on for what you need to know about endocarditis, including symptoms, causes, key terms and ways to potentially reduce your risk. Or, visit this link to learn more about how conditions that cause heart failure are diagnosed at Hoag.

What is Endocarditis?

Endocarditis is a medical condition that involves inflammation of the endocardium, which is the inner lining of the heart chambers and heart valves.

The heart chambers are the four hollow spaces inside the heart, while the heart valves are small flaps of tissue that serve as gates to regulate blood flow through the four chambers.

The inflammation that causes endocarditis is usually due to an infection that enters the body and travels to the heart through the bloodstream. If the heart has damage due to a cardiac condition or a previous cardiac procedure, that can give the infection a place to enter the heart muscle. From there, the infection can spread to the endocardium.

Without treatment, endocarditis can be dangerous and even life-threatening, putting those with the condition at risk of severe damage to the heart or heart valves and sudden death.

What is the Endocardium?

Inside the heart are four hollow spaces called heart chambers. The upper chambers of the heart are called the atria, while the lower chambers are called the ventricles. These four chambers are interconnected by four gates known as the heart valves.

Lining both the heart chambers and heart valves is a thin, smooth layer of tissue known as the endocardium. This inner lining serves as a barrier between the cardiac muscle and the bloodstream, making it essential for the health of the heart.

Because it is in constant contact with the bloodstream, the endocardium is sometimes exposed to bacteria or other types of germs. Normally, a healthy endocardium can resist infection.

However, issues like heart damage from cardiac conditions or prior heart surgery can create a section of tissue which bacteria or other germs can attach to. That can lead to an infection, which can eventually progress into life-threatening inflammation of the endocardium.

What Causes Endocarditis?

A variety of conditions, lifestyle factors and medical issues can cause endocarditis or the heart damage that can lead to infection.

These issues may include:

Congenital Heart Defects

In rare cases, a person can be born with a congenital heart defect, which means a problem with the structure of the heart that occurred as it formed in the womb. While some congenital heart defects are so minor that they are undetected, others may result in critical congenital heart defects, which require surgical treatment within the first year of life. Some congenital heart defects can put a person at increased risk of cardiac complications, including endocarditis. These defects can damage the inner lining of the heart, leaving the endocardium vulnerable to infection.

Dental Procedures

Certain dental treatments can result in damage to the soft tissue inside the mouth, including the gums or the oral mucosa, which is the membrane or “skin” inside the mouth. This can allow oral bacteria to enter the bloodstream. From there, the bacteria can potentially spread to the heart, causing endocarditis.

Complications from Heart Valve Surgery

A damaged heart valve may require treatment by a doctor in the form of a heart valve replacement or a heart valve repair. While these procedures are important in avoiding a range of problems that can be caused by valvular disease, surgical procedures involving the heart or the heart valves can lead to a patient becoming more vulnerable to endocarditis.

Heart valve surgery can create an area of heart damage onto which bacteria can attach, which can lead to endocarditis. A doctor will typically prescribe a round of antibiotics following invasive heart surgery to prevent endocarditis.

The installation of an artificial valve can lead to a particular type of endocarditis known as prosthetic valve endocarditis, which studies have shown to be responsible for 20% of all cases of endocarditis.

Intravenous Drug Abuse

Certain forms of illegal drugs are taken intravenously, meaning these drugs enter the body by direct injection into the bloodstream with a hypodermic needle. Users run the risk of introducing germs into the bloodstream. That can lead to an infection that spreads to the lining of the heart, causing endocarditis.

Other Causes that Can Damage the Inner Lining of the Heart

A variety of causes can increase the risk of dangerous bacteria getting into the bloodstream, which can then attach to and damage the heart. These causes include:

• Other forms of surgery: While heart valve surgery carries the biggest risk of endocarditis, most types of invasive surgery carry a minor risk of introducing bacteria into the bloodstream.
• Poor dental hygiene: A lack of proper dental care can cause deposits of bacteria in the mouth. When a patient brushes their teeth after a long hiatus, these clumps of bacteria can break up, entering the bloodstream through cuts in the oral mucosa and potentially leading to an infection of the heart.
• Pre-existing infection: Ranging from gum disease to skin infections, the average person will typically deal with hundreds of instances of infection throughout their life. However, infection on the skin can sometimes enter the bloodstream through a cut or sore and spread to the heart.
• Medical Procedures Involving an Instrument: Any medical procedure that involves the insertion of a medical instrument into the body carries a small risk of introducing bacteria into the bloodstream.

What are the Symptoms of Endocarditis?

The symptoms of endocarditis can vary depending on the cause and severity of the condition. In cases of acute endocarditis, symptoms can develop quickly over the course of a few days. In cases of subacute endocarditis, which is more common in those with congenital heart disease, symptoms can develop over the course of weeks or even months.

Generally, the most common symptoms of endocarditis are:

• Flu-like symptoms, which may include fever, chills, unusual fatigue, a persistent aching in the muscles, night sweats or headaches
• Persistent coughing
• Shortness of breath, particular during physical activity

Other, less common symptoms of endocarditis include:

• Sudden, unexplained loss of appetite
• Unexpected weight loss
• Confusion
• Painless red spots on the soles of the feet or the palms of the hands
• Painful red lumps on the fingers or toes
• Narrow, reddish-brown lines of blood visible beneath the fingernails
• Petechiae, which are small red, brown or purple spots on the skin

Can Endocarditis Cause Any Serious Complications?

Endocarditis is a severe and potentially life-threatening infection that can both create dangerous heart damage and lead to several serious complications. These complications include:

• Heart failure: a condition in which the heart is unable to pump enough blood to keep the organs and tissues healthy. If not treated properly, heart failure can eventually result in sudden death.
• Emboli: Emboli are clumps of material which can freely travel through the blood. These clumps, sometimes made of blood clots or deposits of bacteria, can result in life-threatening problems for the cardiovascular system. Emboli can travel to arteries of the brain, spleen, bowel, arms or legs, where they can potentially lodge into vital arteries.
• Aneurysms: An aneurysm occurs when the walls of an artery, a type of blood vessel, weaken to such an extent that the artery abnormally balloons outward. An aneurysm, particularly within a vital organ such as the brain, can become a life-threatening condition if not treated properly.
• Kidney injury or disease: In some cases, endocarditis can induce rapidly progressive cases of glomerulonephritis, a medical term for the inflammation or damage to the filtering part of the kidneys. This can quickly lead to end stage renal failure, in which the kidneys are unable to filter blood adequately. Renal failure may require lifelong care and treatment to prevent death.

Who is Most at Risk to Develop Endocarditis?

Endocarditis primarily occurs in patients who suffer from a combination of two factors: those who have a higher risk of blood-borne infections, and those who have preexisting heart damage. These factors in tandem can put a patient at increased risk of endocarditis.

Those who have an increased chance of developing endocarditis include:

• People with heart disease: Diseases of the heart or the heart valves can create areas of damaged heart tissue which are vulnerable to infection.
• People who recently underwent heart surgery: Heart tissue that was cut or stitched during heart surgery will gradually heal. During this period, a patient is at increased risk of endocarditis, particularly in cases where they do not take the antibiotics as prescribed.
• Intravenous drug users: Intravenous drug abuse can increase a patient’s chance of blood-borne infections such as endocarditis.
• Those with poor dental health: A failure to brush or floss one’s teeth can lead to the development of oral bacteria within the mouth, which can then enter the bloodstream via a cut on one’s gums. Some dental procedures, such as invasive forms of dental surgery, can also create cuts through which bacteria can enter the bloodstream.

Are There Any Ways to Reduce My Risk of Developing Endocarditis?

Though there is no way to definitively prevent a person from developing endocarditis, there are certain steps you can take to potentially reduce your risk. Steps you can take to avoid an endocarditis diagnosis may include:

• Practice Good Hygiene – Good bodily hygiene can reduce the chances of infection on various parts of the body. While these infections may only be a minor irritation, they can potentially spread to the cardiovascular system, causing endocarditis. Washing regularly can reduce the chances of these infections developing, lowering a patient’s overall risk of endocarditis.
• Practicing good hygiene also extends to the health of a patient’s gums and teeth. Oral bacteria can proliferate in a patient’s mouth if they don’t brush and floss their teeth very often.
• Follow the Recommendations Given by Your Doctor After Any Medical Procedures – Following certain invasive forms of heart surgery, your doctor may prescribe a round of antibiotics. These help to prevent endocarditis and other infections. Following the recommendations of your doctor exactly when it comes to antibiotics can be very important in preventing complications after heart surgery, including endocarditis.
• Get Blood Culture Tests and Other Medical Screenings Regularly – Patients with risk factors for endocarditis should make full use of the services offered by their healthcare provider, particularly when it comes to early detection. That includes making regular visits to your doctor’s office to receive health screenings, including tests for various cardiac conditions and infections that can increase your risk for endocarditis.

Visit our endocarditis treatment page or endocarditis diagnosis and testing page to learn more.

Looking for an Endocarditis Specialist in Orange County? You Need Hoag.

From Long Beach to San Clemente, those who need cardiac care in Orange County know they’ll find the best at Hoag.

U.S. News & World Report rated Hoag among the best hospitals in the nation for Heart Failure in 2023-2024.

So don’t wait. If you’ve been diagnosed with endocarditis, you need the most experienced team, a diagnosis you can count on and cardiac treatment options that help get you back to living life to the fullest. You need Hoag. Contact us today through our online form or by calling 949-764-5384.