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Infective (bacterial) endocarditis


What is 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 (in addition to bacteria) may cause the disease.

Who is at risk? 

People with underlying heart conditions such as a heart valve replacement or repair, or rheumatic heart disease are most susceptible.

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.

Causes

Infective endocarditis occurs when bacteria or other organisms enter the bloodstream and build up on a valve or in the lining of the heart where damage may have occurred.

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 

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.

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 or ASA (acetylsalicylic acid) may cause complications like excessive bleeding during dental procedures. Talk to your doctor about how to prepare.

Preparing for 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.

The Canadian Dental Association has a Position Statement on Prevention of Infective Endocarditis. It provides a list of heart conditions in which antibiotics  are recommended before certain dental procedures.

Related information

To find useful services to help you on your journey with heart disease, see our list of government and community agencies.

 

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