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Endocarditis - Infection of the Heart Valves 

Introduction
Endocarditis is an inflammation of the endocardium, the inner lining of the heart chambers and valves.  It may occur following a bacterial or fungal infection or for unknown reasons.  Endocarditis produces a variety of symptoms, and if left untreated, can lead to life-threatening medical complications.  Early diagnosis and treatment is associated with the best outcomes.

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Anatomy
Your heart is divided into four sections called chambers.  The chambers are separated by the septum, a thick muscle wall.  The two top chambers are called atria, and they receive blood coming into the heart.  The two bottom chambers are called ventricles, and they send blood out from the heart.
 
Your heart contains two pumping systems, one on its left side and one on its right side.  The left-sided pumping system consists of the left atrium and the left ventricle.  Your left atrium receives blood that contains oxygen, which comes from your lungs.  Whenever you inhale, your lungs move oxygen into your blood.  The oxygenated blood moves from the left atrium to the left ventricle.  The left ventricle sends the oxygenated blood out from your heart to circulate throughout your body.
 
The heart’s right-sided pumping system consists of the right atrium and the right ventricle.  Your right atrium receives deoxygenated blood, blood that has circulated throughout your body and does not have high levels of oxygen in it anymore.  The deoxygenated blood moves from the right atrium to the right ventricle.  The right ventricle sends the blood to the lungs where it receives oxygen when you breathe.
 
As the blood travels through the heart chambers, four valves keep the blood from back flowing.  The mitral valve and the tricuspid valve regulate blood flow from the atria to the ventricles.  The aortic valve and the pulmonary valve control blood as it leaves the ventricles.
 
The heart has several large arteries and veins connected to it that branch out and become smaller as they travel throughout your body.  Your arteries deliver and veins return blood throughout your body in a process called circulation.  Arteries are blood vessels that carry oxygenated blood away from your heart.  Veins are vessels that carry blood from your body and lungs back to your heart.

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Causes
Endocarditis is an inflammation of the endocardium, the inner lining of the heart chambers and valves.  Bacterial infection is the most frequent cause of endocarditis.  However, it may also be caused by fungal infections and for unidentified reasons.  Most people that develop endocarditis have heart valve disease, congenital heart disease, or a history of surgical heart repair.  Endocarditis can occur after dental procedures or surgery.  It is associated with infections from intravenous drug use, body piercing, tattooing, and sexually transmitted diseases.

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Symptoms
Endocarditis can produce a variety of symptoms that may develop slowly or suddenly.  You may have flu-like symptoms that last for awhile.  These may include fever, chills, night sweats, poor appetite, weight loss, and feeling tired or weak.  You may experience muscle aches and joint pain. 
 
Endocarditis can also cause symptoms that develop quickly, including high fever, intense chills, and vomiting.  Your feet, legs, and abdomen may swell.  You may have shortness of breath with activity.  Your urine may look a different color or contain blood.  Your skin may look pale and have red skin spots or rashes.  The skin beneath your fingernails may have small amounts of bleeding under the nail.  Your fingertips may enlarge, and appear to curve or be club-shaped.

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Diagnosis
You should contact your doctor immediately if you suspect that you have endocarditis.  Your doctor will review your medical history and conduct a physical examination and tests.  You should tell your doctor about your risk factors, including recent dental procedures or surgery.  Your doctor will listen to your heart with a stethoscope to hear if you have a heart murmur.  Your blood will be checked for signs of infection. 
 
Your heart structure and functioning may be checked with a variety of methods.  You may receive a chest X-ray to provide an image of your heart and lungs.  An echocardiogram uses sound waves to produce an image of your heart and its valves on a monitor.  An electrocardiogram (ECG) is used to record your heart’s electrical activity and detect abnormal heart rhythms.

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Treatment
Hospitalization may be required to treat infections with intravenous (IV) antibiotics.  This may be followed by a period of long-term antibiotics.  Surgery may be necessary if heart damage or serious complications occur.

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Prevention
It is important to contact your doctor immediately if you suspect that you have endocarditis.  As a preventative measure, you should receive antibiotics prior to dental treatment or surgery if you are at risk for endocarditis.

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Am I at Risk
Anyone may develop endocarditis, but people with heart valve disease, congenital heart disease, or a history of heart surgery have the highest incidences of the condition.  Endocarditis may occur from bacterial infections following dental procedures or surgery.  IV drug abusers who do not use clean needles are at a higher risk.  It is important for people at risk for endocarditis to receive antibiotics prior to dental work or surgery.

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Complications
Early diagnosis and treatment is associated with the best outcomes.  If treatment is delayed, serious life-threatening complications may occur, including blood clots, stroke, and congestive heart failure. 

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.