Infective endocarditis

Infective endocarditis (also called bacterial endocarditis) is an infection of the heart valves or lining of the heart. The name of this condition has changed because we now know that other organisms besides bacteria may cause the disease.

Causes
This problem happens when bacteria or other organisms in your bloodstream collect on a valve or in the lining of your heart where there was previous damage. Usually this occurs in people with underlying heart conditions such as those who have had a heart valve replacement or repair, or rheumatic heart disease.

Symptoms
Symptoms of endocarditis include, fever, chills, weakness, fatigue, aching joints and muscles, night sweats, shortness of breath, paleness, persistent cough, swelling in the feet, legs or abdomen, unexplained weight loss, blood in urine, a new heart murmur, tenderness in the spleen.

Diagnosis
Diagnosing endocarditis usually involves:

Blood tests
Chest X-rays
Echocardiogram

Treatment
Endocarditis is treated with long-term courses of intravenous antibiotics. In severe cases, heart valve replacement may be needed if your heart is not pumping effectively or the infection is not responding to the antibiotics.
Prevention
If you are at high risk of infective endocarditis, any situation that could allow bacteria to enter your bloodstream puts you at risk for infection. This can range from having your teeth cleaned to complex surgery. Talk to your doctor about how to reduce your risk by consistently using antibiotics prior to these procedures to prevent infection.

Dental care
If you have heart valve problems, artificial heart valves or certain other cardiovascular problems, talk to your doctor about taking antibiotics before having any dental work done in order to reduce your risk of infection of the heart.

Precautions
If you are taking medications for your heart conditions, check with your doctor to be sure your medications will not cause problems when you have dental work. If you were born with a heart problem or have had a valve replacement, you are at a greater risk for heart infections (infective endocarditis) resulting from dental or medical procedures. Also, some heart medications such as anti-platelets (ASA, acetylsalicylic acid) may cause complications, like excessive bleeding, during dental procedures. Talk to your doctor about how to prepare.

What to do before dental work?
If you have a heart problem, before having dental work you should:

  • Ask your doctor if any special preparation is needed
  • Discuss your condition with the dentist prior to treatment
  • Know the names of any medications you are taking
  • Be prepared to give the dentist your doctor's name and address
  • Be prepared to give permission for the dentist to consult your doctor.

Last reviewed April 2007.