Endocarditis

Symptoms may appear quickly, within a few days of infection. In other cases, they may develop more slowly. The symptoms will get worse as the bacteria or fungi grow in your heart.

Symptoms may include:

• Flu-like symptoms such as fever, chills, night sweats, and fatigue. These are often the first symptoms.
• Weight loss.
• Muscle or joint pain.
• Cough.
• Shortness of breath.
• Blood under the fingernails or tiny purple and red spots under the skin.

See your doctor if you have symptoms like these that don't go away, especially if you are at risk for endocarditis.

If endocarditis isn't treated soon, it can lead to more serious problems, such as:

• Heart failure.
• An abscess in the heart.
• Heart rhythm problems.
• Heart attack or stroke.
• Infections in other organs, such as the lungs, brain, or kidneys.

Practice good oral hygiene by brushing and flossing your teeth daily. See a dentist twice each year. Tell your dentist that you are at risk for this infection.

You may need to take antibiotics before some dental and medical procedures if you:

• Have had a heart valve replaced or repaired.
• Have had endocarditis before.
• Have had certain heart problems since birth.
• Have heart valve problems after a heart transplant.

Ask your doctor or dentist if you need antibiotics to prevent this infection. Find out when you will need to take them.

Your doctor may give you a card that says you may need preventive antibiotics before some procedures. You can keep it in your wallet.

First, your doctor will ask about your medical history and your symptoms. The doctor will also do a physical exam to check for signs of the infection. These signs include a heart murmur, an enlarged spleen, and bleeding under the nails.

Your doctor may also do tests, such as:

• Blood cultures. These tests look for bacteria in your bloodstream.
• Echocardiogram. This is done to check your heart for problems such as infected areas or heart valve defects.
• Electrocardiogram (EKG or ECG). This test checks for heart rhythm problems.
• A chest X-ray. This is to see if your heart is enlarged or if you have signs of heart failure.
• An MRI (magnetic resonance imaging) test or a CT scan. These may be done as additional tests to check your heart for problems.

Endocarditis is usually treated with antibiotics. You will probably need several weeks of treatment. The antibiotics must be given long enough and at a strong enough dose to destroy all of the bacteria.

At first you will be treated in the hospital. This is so that antibiotics can be given through a vein (IV). After your fever is gone and you are stable, you may be able to continue IV antibiotics at home. A home health nurse can help you with this.

After you have been treated with IV antibiotics, your doctor may want you to take antibiotic pills. If so, take them exactly as prescribed until they are gone. If your symptoms come back, call your doctor right away. You probably will need more antibiotics if testing shows that the bacteria were not completely destroyed.

Some people who have endocarditis need surgery to repair or replace a heart valve or to prevent complications.

You may have follow-up visits for months or years to check the health of your heart.