A Simple Guide To Endocarditis: What Causes It And Who Is At Risk?

There are several types of heart conditions that can be life-threatening if not treated on time. This includes endocarditis, a condition that occurs when bacteria or other germs enter the bloodstream and travel to the heart, leading to inflammation of the inside lining of the heart chambers and heart valves, known as the endocardium.

In an interaction with the OnlyMyHealth team, Dr Varun Bansal, Consultant Cardiologist, Apollo Clinic, Delhi, explains that endocarditis can be acute, developing rapidly, or chronic, progressing over weeks to months. If left untreated, it can lead to serious health issues like heart failure, stroke, or organ damage, making early diagnosis and treatment crucial, he adds.

Also Read: Myocarditis? Symptoms, Causes And Treatment

What Causes Endocarditis?

It is important to note that endocarditis is a rare condition with an estimated annual incidence of 3–10 cases per 100,000 people, according to StatPearls Publishing.

In developed countries, the incidence of endocarditis ranges from 2.6 to 7 cases per 100,000 population per year, research notes, adding that the median age of patients with endocarditis is 58 years.

According to Dr Bansal, endocarditis is primarily caused by bacteria entering the bloodstream and infecting the heart’s inner lining.

Common culprits include Streptococcus, Staphylococcus, and Enterococcus species, he says.

Who Is At Risk Of Endocarditis?

Dr Bansal shares common risk factors for endocarditis, which include:

• Pre-existing heart conditions, such as defective or artificial heart valves
• Congenital heart defects
• A history of intravenous drug use
• Individuals with weakened immune systems
• Those undergoing dental or surgical procedures
• People with chronic health issues like diabetes or cancer

Common Symptoms To Watch Out For

Here are some common symptoms of endocarditis to watch out for:

• Fever and chills
• Night sweats
• Fatigue and weakness
• Joint and muscle pain
• Unexplained weight loss
• Skin changes like petechiae (small red or purple spots), Janeway lesions (painless lesions on palms and soles), and Osler nodes (painful nodules on fingers or toes)
• A new or changed heart murmur

Dr Bansal advises prompt recognition and treatment as critical steps to prevent complications.

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Diagnosis And Treatment

The diagnosis of endocarditis involves a combination of clinical evaluation, blood tests, and imaging studies, according to the expert.

“Blood cultures are crucial to identifying the infecting organism and determining the appropriate antibiotic treatment. An echocardiogram, either transthoracic or transesophageal, helps visualise heart valve abnormalities and vegetation. Additional tests may include chest X-rays, electrocardiograms (ECGs), and sometimes MRI or CT scans to assess the extent of infection and associated complications,” he says, adding that a thorough history and physical examination are also vital in identifying risk factors and guiding diagnostic decisions.

Treatment usually involves a prolonged course of intravenous antibiotics to eradicate the infection, tailored based on the identified microorganism, according to Dr Bansal.

In some cases, surgery may be required to repair or replace damaged heart valves, especially if there is significant valve dysfunction or persistent infection despite antibiotics, he shares, concluding that supportive care may include medications to manage symptoms and complications, such as heart failure.