Infective Endocarditis

woman with symptoms of infective endocarditis

About 34,000 cases of infective endocarditis are reported each year. A dangerous condition, infective endocarditis (IE) refers to bacteria-caused damage to the inner lining of the heart, called the endocardium, or heart valves. Left untreated, it could cause serious heart damage or death. While considered fairly uncommon, it tends to appear in those with previous heart damage and others who are exposed to bacteria. Also called bacterial endocarditis, it is considered a non-contagious chronic infection.

How Infective Endocarditis Damages the Heart

IE can lead to heart disease, stroke and irregular heart rhythms. It limits the heart’s capacity to pump blood that carries oxygen and nutrients to all parts of the body.  There are two types of infective endocarditis. Acute endocarditis happens suddenly and could be life-threatening within days. It is also possible for a longer-term IE development to take place, known as sub-acute or chronic bacterial endocarditis.

Bacteremia, the entry of bacteria into the bloodstream, becomes dangerous when bacteria attaches to blood components like platelets or fibrin. This causes a buildup to begin. Called “vegetation,” the buildup causes inflammation or infection to the endocardium or heart valves. It can also attach to pacemakers, artificial heart valves or other implanted devices.

Bacteria Entry Into the Cardiovascular System

Several risky entry opportunities for bacteria into the bloodstream have been known for many years. They include congenital heart disease, rheumatic fever, major dental work and open heart surgery. Genitourinary procedures, which involve urinary and genital organs, are also closely watched. Those who have had previous valve surgery, transplants or calcium deposits in the mitral or aortic valve are also susceptible. Leaving minor cuts untreated allows bacteria to enter the bloodstream.

More recently, the Centers for Disease Control and Prevention (CDC) has identified certain social habits and behaviors as entry points for bacteria. The recent trend of body piercing increases risk, as does alcohol consumption in excess and the use of illicit drugs involving a needle.


Common symptoms of IE are fatigue, aches and pains, weakness and shortness of breath. A mild fever or relatively fast heartbeat can also occur. Additionally, weight loss, chills and night sweating can signal infective endocarditis. Heart murmurs, swelling in the legs and feet, blood in urine and painful, red nodes in fingers and toes could be signs, too.


It is important to note that not all bacteria are causes for IE. In most cases, the body’s immune system eliminates harmful bacteria. With an early diagnosis, infective endocarditis is very treatable. It is important that a physician and cardiologist be notified if any IE symptoms occur. Once the risk is determined, several treatment methods are available. Antibiotics may be prescribed that will eliminate the infection.

Surgery may be required, especially in the early stages of acute infective endocarditis. In some cases, the surgery may not be required immediately. Upon evaluation by the cardiologist, a procedure may be scheduled later, depending on the progress of antibiotics or if progression of the endocarditis is detected.

Infective Endocarditis Prevention Methods

Detection and early reporting of any IE symptoms can prevent major occurrences. Those who have had IE before are susceptible and they should be especially vigilant for symptoms.

Since the mouth and subsequent dental procedures are gateways for bacteremia, good dental health is advised. The American Heart Association (AHA) offers some preventative advice regarding dental surgery. While not everyone scheduled for dental surgery needs antibiotics, in some cases, they are prescribed. These cases include issues involving gingival tissues, periapical procedures (relating to inflammation around the root of a tooth) or the perforation of the membrane lining the mouth. If dental procedures are required, these precautions may be advised.

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