Bacterial endocarditis (also known as infective carditis or SBE) occurs when germs or bacteria enter your blood and attack the lining of your heart valves. Bacterial endocarditis causes growths or holes on your valve or scarring of the valve tissue, most often resulting in a leaky heart valve. Without treatment, bacterial endocarditis can be fatal. Normally bacteria is found in the mouth, on the skin, in in the intestines and the urinary tract. If bacteria enter the bloodstream, it can cause endocarditis.
- Fever (particularly over 100 degrees F or 38.4 degrees C)
- Sweats or chills
- Skin rash
- Pain, tenderness, redness, or swelling
- Wounds or cuts that won’t heal
- Red, warm, or draining sore
- Sore throat, scratchy throat, or pain when swallowing
- Sinus drainage, nasal congestion, headaches or tenderness along upper cheekbones
- Persistent dry or moist cough that lasts more than 2 days
- White patches in your mouth or on your tongue
- Nausea, vomiting, or diarrhea
The American Heart Association recommends antibiotics to prevent endocarditis for those with the highest risk of adverse outcomes. The cardiac conditions associated with the highest risk for which prevention is recommended includes:
- Those with an artifical (prosthetic) heart valve, including bioprosthetic and homograft valves
- Previous bacterial endocarditis
- Congenital heart diseases (for example, single ventricle states, Tetralogy of Fallot, transposition of the great vessels). This includes unrepaired cyanotic congenital heart disease and those with repaired congenital heart disease or device during the first 6 months after the procedure
- Cardiac transplantation recipients
How it is Diagnosed:
The diagnosis is based on symptoms, clinical findings and the results of diagnostic tests.
Blood cultures show bacteria or microorganisms commonly found with bacterial endocarditis. Blood cultures are blood tests taken over time that allow the laboratory to isolate the specific bacteria causing the infection.
An Echocardiogram shows growths, abscesses (holes), new regurgitation (leaking) or stenosis(narrowing), or an artifical valve that has begun to pull away from the heart tissue.
Once blood cultures or test results indicate the specific bacteria causing the endocarditis, a course of intravenous (IV) antibiotics is started and may be given as long as 6 weeks to control the infection. Symptoms are monitored throughout the therapy and blood tests performed to determine the effectiveness of treatment. If heart valve damage has occurred, surgery may be required to fix the heart valve and improve heart function.
Bacterial endocarditis treatment begins with infection. After endocarditis occurs, quick treatment is needed to prevent damage to the heart valves and more serious complications such as death.
How can you protect yourself from bacterial endocarditis?
Determine with your provider what your risk category is and if you require bacterial endocarditis protection. It is rare for those in the non-risk group to develop bacterial endocarditis and protection may not be necessary. If you are in the high or moderate risk group, please follow these guidelines:
1. Tell your providers and dentists you have heart disease and that you are at risk for endocarditis.
2. Call your provider if you have symptoms of an infection. Do not wait a few days until you have a major infection to seek treatment.Colds and flu do not cause endocarditis, but infections that may have the same symptoms (sore throat, general body aches, and fever) do. To be safe call your provider.
3. Take good care of your teeth and gums by seeking professional dental care on a regular basis, brush and floss regularly, and make sure your dentures fit properly.
4. Take antibiotics prior to procedures that may cause bleeding, including professional teeth cleaning or other dental procedures that may cause bleeding, invasive tests (such as scopes to look inside your respiratory tract, stomach, intestines, bowel, or bladder), some major and minor surgeries (involving the respiratory tract, stomach, intestines, bowel, colon, urinary tract, gall bladder or prostate), and other types of procedures if the tissue is infected. Check with your provider about the type and amount of antibiotic you should take. A wallet card may be obtained from the American Heart Association or call your local American Heart Association office or nationally at 1-800-AHA-USA1.