What is endocarditis?
Endocarditis is inflammation of the endocardium, the layer of tissue that lines your heart valves and chambers. Most often caused by an infection, endocarditis occurs when germs enter your bloodstream, travel to the heart and attach to the endocardium—usually to the surfaces of one of the four heart valves. Without swift treatment, endocarditis can cause serious health problems and may be life-threatening.
Types of endocarditis
Providers often refer to endocarditis as infective, as most cases are caused by a bacterial infection, but it can also be caused by a viral or fungal infection. Bacteria or fungi join with proteins and blood cells to form clumps called vegetations on the endocardium. If these buildups break loose, they can cause a spread of the infection to other organs or restrict blood flow to organs such as the heart or brain.
Less commonly, endocarditis can be noninfective, which means only proteins and blood cells form vegetations. Doctors aren’t sure why noninfective endocarditis occurs.
Endocarditis is also categorized by how quickly or when it develops. Types include:
- Acute endocarditis: This type develops suddenly and, within days, may become life-threatening, which makes prompt treatment essential.
- Subacute endocarditis: This type forms more slowly than acute endocarditis, taking weeks or months to develop.
- Prosthetic valvular endocarditis: This type develops after heart valve replacement surgery if the germs become attached to the prosthetic valve.
Endocarditis symptoms
Endocarditis symptoms vary from person to person depending on the type of infection. With acute endocarditis, symptoms may occur without warning. With subacute endocarditis, symptoms may develop gradually. Severe symptoms may make you feel very ill. Some people, though, experience only mild symptoms.
Symptoms of endocarditis include:
- Back, muscle or joint pain
- Blood in your urine
- Chest pain
- Chills
- Cough
- Fatigue
- Fever
- Heart murmur
- Night sweats
- Red or purple bumps or other skin changes
- Shortness of breath
- Stomach pain
- Weight loss
When to see a doctor
See your primary care doctor if you have endocarditis symptoms or signs of an infection, such as a fever and body aches. Endocarditis is rare, and having an infection does not mean you will necessarily develop the infection in your heart. Still, seeking treatment for an infection as soon as possible can help you avoid serious complications. Similarly, diagnosing and treating endocarditis quickly protects your heart from long-term damage.
Endocarditis causes
In most cases, endocarditis occurs due to infection by bacteria. These bacteria may live on your body or in your mouth. They may also come from an infection elsewhere in your body, such as the urinary tract. Bacteria can enter your bloodstream through cuts or scratches or during dental or surgical procedures.
Less commonly, infections with yeast or other fungi can also cause endocarditis. Yeast, like some bacteria, can also live on your body and enter the bloodstream through wounds or surgery.
Endocarditis risk factors
Many factors can increase your risk for endocarditis. Some of these factors, such as having certain heart conditions or a weakened immune system, are outside of your control. However, other factors, such as poor oral or skin health, are within your control.
Knowing your risk factors can help you and your doctor understand your chances of developing endocarditis, and you can take steps to prevent infection and protect your heart.
Risk factors for endocarditis include:
- Age: Adults older than 65 are more likely to get endocarditis. Age-related changes to the heart valves, such as calcium deposits, give germs more landing spots.
- A history of endocarditis: If you’ve had endocarditis before, your heart tissue may have sustained damage that makes additional inflammation more likely.
- Artificial heart valves: Bacteria may be better able to attach to the foreign material of a prosthetic heart valve than native valve tissue.
- Congenital heart disease: Heart abnormalities that exist at birth, such as narrow valves, provide easier places for germs to collect.
- Heart valve disease: If you have a damaged heart valve, germs may be able to attach to it more easily.
- Implanted heart devices: Bacteria may attach to a pacemaker, cardioverter defibrillator or another implanted device, and trigger inflammation.
- Long-term IV use: Consistently receiving medications or using illicit drugs through an IV may allow germs to enter the bloodstream.
- Poor oral health: Not taking care of your teeth and gums can allow bacteria to build up and, potentially, enter the bloodstream.
- Weakened immune system: If your immune system isn’t as strong as it should be, it may struggle to destroy invading bacteria or fungi.
Complications
Without timely treatment, endocarditis can lead to serious health problems or death. Certain serious health problems can occur if the vegetations that form on the endocardium break free and block blood flow to important organs. In other cases, complications may arise due to damage to the heart or your body’s reaction to the infection.
Possible complications of endocarditis include:
- Abscesses: Vegetations on the endocardium may cause abscesses (pockets of pus) to form near the affected tissue.
- Arrhythmia: Damage to the heart may interfere with the organ’s pumping ability and cause it to beat irregularly.
- Heart attack: A vegetation that breaks loose from the endocardium may block an artery in the heart, causing a heart attack.
- Heart failure: If endocarditis damages the heart valves, the heart may have to work harder to pump blood, leading to heart failure.
- Heart valve damage: Vegetations that form on the endocardium can cause holes in the valves, which may worsen their function.
- Sepsis: This condition occurs when your body overreacts to an infection, potentially leading to dangerously low blood pressure and organ failure.
- Stroke: A stroke may occur if a vegetation separates from the endocardium and blocks an artery that feeds blood to the brain.
Diagnosing endocarditis
Your doctor will ask about your health history, including any heart conditions or procedures that could increase your risk for endocarditis. They will also want to learn about your symptoms. The doctor will check you for signs of endocarditis, such as a heart murmur. Finally, they will order blood and imaging tests to look for infection and determine how well your heart is working.
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Medical history
Your doctor will inquire about your medical history, including any chronic conditions you have and how you’re managing them. They’ll want to know about any heart conditions, such as heart valve disease, heart surgeries or implantable cardiac devices, which could increase your risk for endocarditis.
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Exam
Your doctor will ask about your symptoms, including when they started, whether they occurred suddenly or gradually, what they feel like, what parts of your body they affect and how they affect your daily functioning.
Your doctor will conduct a physical exam to look for signs of endocarditis. They will take your temperature to check for a fever and listen to your heart to see if they hear a murmur.
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Imaging and tests
After gathering information about your medical history and symptoms and examining you, your doctor may order some tests to gather more insight about your condition. These tests may include:
- Blood tests: Blood tests can show potential signs of infection, such as a high white blood cell count, and identify infection-causing germs.
- Echocardiogram: An echocardiogram uses sound waves to create images that can show vegetations on the endocardium and complications, such as abscesses.
- Cardiac MRI scan: This imaging test uses powerful magnets and radio waves to create images that may show vegetations and problems with the valves.
- Chest X-ray: A chest X-ray can show whether the heart is swollen or whether fluid buildup or other possible signs of infection are present in the lungs.
- Cardiac CT scan: This test can help to identify if any abscesses have formed on or around the heart and the involvement of the valves.
Endocarditis treatment
If your doctor diagnoses endocarditis, they will begin treatment quickly to prevent serious complications. You will receive medication to treat the microorganisms responsible for the infection.
Medication
Doctors use two main types of medication to treat endocarditis. Which type you receive depends on what caused the infection.
- Antibiotics: If you have bacterial endocarditis, you’ll receive antibiotics. At first, you may get a medication that targets a wide range of bacteria. Later, though, doctors may change the medication to treat the specific bacteria responsible for your infection.
If you need antibiotics, you will likely stay in the hospital for several days so you can receive medication through an IV. During this time, doctors will monitor your response to the medication to ensure your symptoms improve. You may need antibiotics for several weeks to eliminate the infection. - Antifungals: You’ll need an antifungal medication for endocarditis caused by fungi. You may need to take this medication for the rest of your life to prevent future inflammation of the endocardium.
If endocarditis damages a heart valve or keeps returning, heart valve surgery may be necessary.
Surgery
In some cases, endocarditis may return even after treatment with medication, or the condition may damage a heart valve so badly that it can’t function correctly. In those situations, surgery may be appropriate.
Depending on your overall health and the condition of your heart, your surgeon may recommend heart valve surgery to repair the damaged valve or replace it with one made of synthetic components or animal tissue.
Locations for endocarditis care
Our heart teams in North and Central Texas have the expertise necessary to treat endocarditis and its possible complications. We can help arrange your care at the location best suited to your needs.
Baylor Scott & White Advanced Heart Failure Clinic - Longview
906 Judson Rd , Longview, TX, 75601
Baylor Scott & White Advanced Heart Failure Clinic - Tyler
1321 S Beckham Ave , Tyler, TX, 75701
Baylor Scott & White Center for Thoracic Surgery - Tyler
1321 S Beckham Ave , Tyler, TX, 75702
Baylor Scott & White Cardiology Consultants of Texas - Greenville
4400 Interstate 30 W Ste 300, Greenville, TX, 75402
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 5:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 5:00 pm
Baylor Scott & White Texas Cardiac Associates - Royse City
6257 FM 2642 Blvd Ste 100, Royse City, TX, 75189
Baylor Scott & White The Heart Hospital - McKinney
5268 W University Dr , McKinney, TX, 75071
Baylor Scott & White The Heart Group - McKinney
5236 W University Dr Ste 4450, McKinney, TX, 75071
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 7:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 5:00 pm
Baylor Scott & White Legacy Heart Center - McKinney
5236 W University Dr Ste 4100, McKinney, TX, 75071
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Cardiac Surgery Specialists - McKinney
5236 W University Dr Ste 4900, McKinney, TX, 75071
Baylor Scott & White Arrhythmia Management - McKinney
5236 W University Dr POB I, Ste 4900, McKinney, TX, 75071
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - McKinney
5252 W University Dr Highway 380 at Lake Forest Drive, McKinney, TX, 75071
Baylor Scott & White Arrhythmia Management - Rockwall
1005 W Ralph Hall Pkwy Ste 225, Rockwall, TX, 75032
Baylor Scott & White Cardiovascular Specialists - Rockwall
6705 Heritage Pkwy Ste 202, Rockwall, TX, 75087
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - Lake Pointe
6800 Scenic Dr , Rowlett, TX, 75088
Baylor Scott & White Center for Thoracic Surgery - Rockwall
6701 Heritage Pkwy Ste 130, Rockwall, TX, 75087
Baylor Scott & White Legacy Heart Center - Prosper
111 S Preston Rd Ste 10, Prosper, TX, 75078
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Arrhythmia Management - Prosper
111 S Preston Rd Ste 10, Prosper, TX, 75078
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White The Heart Group - Prosper
111 S Preston Rd Ste 10, Prosper, TX, 75078
Baylor Scott & White Texas Cardiac Associates - Rowlett
7801 Lakeview Pkwy Ste 100, Rowlett, TX, 75088
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Denton Heart Group - Gainesville
201 N Interstate 35 Ste 140, Gainesville, TX, 76240
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - Frisco at PGA Parkway
7600 Better Way , Frisco, TX, 75033
Baylor Scott & White The Heart Group - Frisco
4461 Coit Rd Ste 101, Frisco, TX, 75035
- Monday: 8:30 am - 4:30 pm
- Tuesday: 8:30 am - 4:30 pm
- Wednesday: 8:30 am - 4:30 pm
- Thursday: 8:30 am - 4:30 pm
- Friday: 8:30 am - 4:30 pm
Baylor Scott & White Medical Center - Centennial
12505 Lebanon Rd , Frisco, TX, 75035
Baylor Scott & White Legacy Heart Center - Garland
7217 Telecom Pkwy Ste 205, Garland, TX, 75044
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Arrhythmia Management - Garland
7217 Telecom Pkwy Ste 205, Garland, TX, 75044
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Texas Cardiac Associates - Forney
763 E US Hwy 80 Ste 240, Forney, TX, 75126
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Legacy Heart Center - Frisco
9990 Dallas Pkwy Ste 100, Frisco, TX, 75033
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Cardiovascular Consultants at The Star
3800 Gaylord Pkwy Ste 910, Frisco, TX, 75034
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 5:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 5:00 pm
Baylor Scott & White Legacy Heart Center - Plano Preston Road
6601 Preston Rd , Plano, TX, 75024
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - Frisco
5601 Warren Pkwy , Frisco, TX, 75034
Baylor Scott & White Legacy Heart Center - Plano Spring Creek Parkway
5655 W Spring Creek Pkwy Ste 155, Plano, TX, 75024
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - Sunnyvale
231 S Collins Rd , Sunnyvale, TX, 75182
Baylor Scott & White Cardiovascular Consultants - Plano
6000 W Spring Creek Pkwy Ste 220, Plano, TX, 75024
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 5:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 5:00 pm
Baylor Scott & White Arrhythmia Management - Plano
1820 Preston Park Blvd Ste 1450, Plano, TX, 75093
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Cardiology Consultants of Texas - Mesquite
1575 Interstate 30 , Mesquite, TX, 75150
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 5:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 5:00 pm
Baylor Scott & White The Heart Hospital - Plano
1100 Allied Dr , Plano, TX, 75093
Baylor Scott & White Cardiac Surgery Specialists - Plano
4708 Alliance Blvd Pavilion I, Ste 540, Plano, TX, 75093
- Monday: 8:30 am - 4:30 pm
- Tuesday: 8:30 am - 4:30 pm
- Wednesday: 8:30 am - 4:30 pm
- Thursday: 8:30 am - 4:30 pm
- Friday: 8:30 am - 4:30 pm
Baylor Scott & White The Heart Group - Plano
4708 Alliance Blvd Pavilion I, Ste 465, Plano, TX, 75093
- Monday: 8:00 am - 4:30 pm
- Tuesday: 8:00 am - 4:30 pm
- Wednesday: 8:00 am - 4:30 pm
- Thursday: 8:00 am - 4:30 pm
- Friday: 8:00 am - 4:30 pm
Baylor Scott & White Cardiovascular Consultants - Plano II
4708 Alliance Blvd Pavilion I, Ste 450 , Plano, TX, 75093
- Monday: 8:30 am - 4:45 pm
- Tuesday: 8:30 am - 4:45 pm
- Wednesday: 8:30 am - 4:45 pm
- Thursday: 8:30 am - 4:45 pm
- Friday: 8:30 am - 4:45 pm
Baylor Scott & White Cardiovascular Specialists - Mesquite
5308 N Galloway Ave Ste 201, Mesquite, TX, 75150
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White The Heart Hospital Heart Rhythm Center - Plano
4716 Alliance Blvd Pavilion II, Ste 300, Plano, TX, 75093
Baylor Scott & White The Heart Hospital Heart Recovery Center - Plano
4716 Alliance Blvd Pavilion II, Ste 350, Plano, TX, 75093
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White The Heart Hospital – Plano Structural Heart Center
4716 Alliance Blvd Pavilion II, Ste 300, Plano, TX, 75093
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Global Heart Health Center
4716 Alliance Blvd Pavilion II, Ste 300, Plano, TX, 75093
Baylor Scott & White The Heart Hospital Aortic Center - Plano
4716 Alliance Blvd Pavilion II, Ste 300, Plano, TX, 75093
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White The Heart Hospital Genetics Center - Plano
4716 Alliance Blvd Pavilion II, Ste 350, Plano, TX, 75093
Baylor Scott & White Medical Center - Plano
4700 Alliance Blvd , Plano, TX, 75093
Baylor Scott & White The Heart Group - Castle Hills
1700 FM 544 Ste 200, Lewisville, TX, 75056
Baylor Scott & White Cardiology Consultants of Texas - Park Cities
9101 N Central Expy Ste 300C, Dallas, TX, 75231
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 5:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 5:00 pm
Baylor Scott & White Arrhythmia Management - Denton
3333 Colorado Blvd , Denton, TX, 76210
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Frequently asked questions
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What bacteria cause endocarditis?
Staphylococci and streptococci bacteria cause most cases of endocarditis. Staphylococci, or staph, bacteria can cause a variety of infections, including skin and bone infections. Streptococci bacteria can cause strep throat and other, more serious infections.
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How do doctors test for endocarditis?
Doctors use several tests to diagnose endocarditis, including blood tests and imaging tests, such as echocardiograms, as well as cardiac CTs and MRIs.
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Can you reverse endocarditis?
You can reverse endocarditis with early diagnosis and treatment, usually with antibiotics. Previously having endocarditis increases your risk of developing it again.
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Can a tooth infection cause endocarditis?
Yes, a tooth infection can cause endocarditis. Bacteria from your mouth may travel through the bloodstream to your heart and infect the endocardium.
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Can you live a normal life after endocarditis?
Yes, you can live a normal life after endocarditis, but timely treatment is essential to prevent serious complications and limit any lasting effects on your heart.
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How long can you have endocarditis and not know it?
If you have subacute endocarditis, you may not know you have it for weeks or months because symptoms develop gradually. This slow progression may cause you to delay seeking help and getting a diagnosis.
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How rare is endocarditis?
Endocarditis is rare, affecting approximately 5 in every 100,000 people per year. It’s more likely in people over the age of 65 and those with pre-existing heart valve issues.