Endocarditis (Infective Endocarditis): Symptoms and Treatment


What is Endocarditis?

Endocarditis, like almost all diseases that end with ïte ”, is an inflammation. Endocarditis is the inflammation of the internal structures of the heart, especially the heart valves.

Endocarditis is caused when bacteria, germs, fungi, viruses or other microorganisms, which are already present in the body, spread through the blood system and attach themselves to affected areas of the heart.

The disease, if caused by an infectious agent, is called infectious endocarditis; if it is caused by a bacterium, it is known as bacterial endocarditis.

Unfortunately, the recurrence of death is high in this disease. About 30% of patients die from endocarditis. Almost one person in three will die


When germs enter the bloodstream, they travel to the heart and attach themselves to valves or tissue, usually because the patient already has a pre-existing condition.

Most of the time, the cause of the disease enters the bloodstream in the following ways:

  • Catheters or needles;
  • Infected areas (skin, intestine, etc.);
  • Cuts in teeth and gums that are not healthy.

The cause of the disease, however much it reaches the heart, does not mean that it will cause the infection. Therefore, those who already have a heart disease or problem are more susceptible to harboring the bacterium or fungus that causes it.

It is still possible to divide into four other factors that collaborate for the infectious agents to affect the heart valves:

Administration of intravenous drugs

When administering medications intravenously (IV) in the hospital, there is special care and cleaning that is done so that bacteria do not stop in the bloodstream.

This care is not done in cases of people who use drugs intravenously, such as heroin and cocaine. As there is a lack of hygiene, bacteria are easily released into the bloodstream.

Artificial heart valves

Patients who have artificial valves that have been placed to replace the natural ones are more likely to develop endocarditis, especially in the first year after replacing these valves.

Previous valve disease

People with heart valve injuries, whether born or acquired, are patients at high risk for endocarditis. In case of acquired disease, it can occur through rheumatic fever . Other factors that can cause endocarditis are: birth defects, aortic or mitral stenosis, coarctation of the aorta or defects in the ventricular septum, tetralogy of Fallot and even prolapse of the mitral valve, if accompanied by mitral insufficiency, can become a factor of risk.

Libman-Sacks endocarditis

Libman-Sacks endocarditis is a rare endocarditis that is not caused by germs or bacteria. It occurs through another disease called Systemic Lupus Erythematosus.

Risk factors

Patients with birth defects, heart valve problems, artificial heart valves and other heart problems are more likely to have endocarditis. The same is true for patients who have problems with gums or teeth, as well as cavities.

Symptoms of Endocarditis

Symptoms usually change according to the degree of the disease and whether there were any heart problems before the infection occurred or not. The most common symptoms are:

  • Tiredness;
  • Pallor;
  • Persistent cough;
  • Short breath;
  • Heart murmur;
  • Pain in muscles and joints;
  • Blood in the urine;
  • Loss of appetite;
  • Sweat on the legs, abdomen or feet;
  • Fever and chills;
  • Unintentional weight loss.


The doctor best suited to treat this type of problem is the cardiologist, but any doctor can identify a problem with the stethoscope, listening for a sign of a heart murmur or any change in your health.

Arriving at the doctor’s office with some information already allows time to be optimized and the diagnosis can be made in advance.

When identifying the type of bacteria that is causing endocarditis, by performing blood culture, the doctor may order additional tests, such as:

  • Chest X-ray;
  • Electrocardiogram;
  • Bloodtests;
  • Transesophageal echocardiogram;
  • Magnetic resonance imaging;
  • Computed tomography.

Treatment for Endocarditis

The treatment usually lasts from four to six weeks and is done with the use of antibiotics, which, for the most part, are intravenous. Depending on the severity of endocarditis, surgery may be necessary and usually occurs if the valve has already been severely damaged.

The antibiotics most used in the treatment of the disease are:

  • Quivering ;
  • Amoxicillin ;
  • Erythromycin .

Although the drugs are indicated in the text, the ideal is always to consult the doctor so that he can provide the necessary information and the correct treatment of endocarditis. The self-medication can bring even greater health problems of the patient.

Although endocarditis is susceptible to health problems, once treatment begins, the effects are usually positive.


NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.


Endocarditis can bring several serious problems to the patient, known as:

  • Heart attack;
  • Cardiac insufficiency;
  • Infection in other parts of the body, such as kidneys, brain, liver or spleen;
  • Damage to other organs or tissues.

In case of bacterial endocarditis, if not treated in time, it usually destroys the heart valve, leading the patient to death. If the death does not happen, health problems can arise:

  • Pulmonary embolism;
  • Limb ischemia;
  • Stroke;
  • Renal infarction;
  • Glomerulonefrite.

How to live with the problem

When carrying out the treatment, the patient is usually able to live well, but needs more hygienic care with the mouth and also take more care of the heart, preventing other problems from arising.


To avoid the problem, maintaining good oral hygiene and seeing the dentist regularly is essential. It is necessary to be attentive to the healing process of tattoos and piercings, so that infections that may cause skin problems and cuts do not occur.

If these problems occur, it is necessary to use antibiotics to prevent the problem from reaching the patient’s heart.

Endocarditis is an inflammation that needs care. If you want to take more and more care of your family and friends, share this text so that they too will be informed and know a little more about the disease.

If there is any doubt, criticism or praise about the text, contact us so that together we can always arrive at the best solution and, thus, take information to others.