Endocarditis: Symptoms, Causes, and Diagnosis

Endocarditis is a condition, in which the heart lining, heart valves, and heart muscles become inflamed. Endocarditis occurs due to bacteria (known as Bacterial Endocarditis), infection (known as Infectious Endocarditis), and fungi (Fungal Endocarditis). The condition can cause damage to the heart valve or other serious problems if left untreated.

Bacteria are all around the environment and some of them also live on different body parts. In case a person is suffering from heart conditions, bacteria in the bloodstream can damage the heart muscles and tissue leading to an infection called Endocarditis.

The bacteria and germs are also transferred from other body parts like the mouth, lungs, etc., and can cause Endocarditis. If these types of infections are not treated on time, it can lead to other serious issues.

In general, it can be categorized into Acute Endocarditis that occurs suddenly and become serious condition within a few days and Chronic Endocarditis that occurs slowly over a period of time.

Some Common Facts of Endocarditis

  • Endocarditis is a type of infection occurs due to fungi, bacteria, and other microorganisms.
  • Most often the condition is caused due to bacteria named streptococcal or staphylococcal.
  • Studies state that Endocarditis affects approximately 4 in 100,000 people each year.
  • Studies show that Endocarditis affects approximately 4 in every 100,000 people every year.
  • According to the NCBI reports, the cases of Endocarditis ranges from 2.6 to 7 per 100,000 people every year in any developed country.
  • According to an article of the MSD, this condition is more common in men and old people (particularly above 60).
  • In most cases, the condition is treatable. Consult the doctors as soon as one notices the symptoms. Also, visit regularly for dental checkups.

Causes of Endocarditis


Endocarditis occurs when the infectious bacteria and fungi entered into the body and affect the heart tissue. This condition also occurs when the normal bacteria that lives inside the mouth and respiratory tract starts to attack the health heart tissue.

Usually, the immune system has the capability to destroy the harmful microorganisms but when they attack to heart tissue, it is hard to destroy them. These harmful organisms then multiply and cause serious issue.

These bacteria affect the heart valve, damage the heart tissue, and disturbs the electrical activity of the heart. Sometimes, these bacteria can also lead to other organs such as kidney, lungs, etc.

These microorganism can entered into the body due to following reasons:

  • Dental problem or dental infection or some dental procedure.
  • Other surgical procedures that affect the digestive tract, urinary tract, breathing tract, skin, muscles, and bones.
  • Heart defect including congenital heart defects, damaged heart tissue, heart valve disease, etc.
  • A bacterial infection such as inflammatory bowel disease and intestine disorder.
  • Sexually transmitted infections (STIs) such as gonorrhea and chlamydia.
  • A candida fungal infection.
  • Surgical or medical tools such as urinary catheters.
  • Body piercing and tattoos needles.
  • Harmful drug use such as cocaine or heroin.

People with the following problem are at risk of developing Endocarditis. So, the risk factors of this condition include:

  • Age over 60 years
  • Male gender
  • A history of Endocarditis
  • Artificial heart valves
  • Damaged heart valves
  • Congenital heart defects
  • Poor dental procedure
  • A history of using harmful substances/ illegal drug
  • Existing heart disease
  • Rheumatic fever
  • Serious bacterial illness like pneumonia and meningitis
  • Weak immune system due to any disease or reasons
  • Have pacemaker
  • Hemodialysis patients

If Endocarditis left untreated the condition can lead to various conditions which include:

  • Heart murmur
  • Heart failure
  • Heart valve disease
  • Seizure
  • Stroke
  • Paralysis (unable to move the body parts)
  • Accumulation of abscesses (pus) in the heart, lungs, brain, etc.
  • Pulmonary embolism
  • Enlarged spleen
  • Kidney damage
  • Arrhythmia (irregular heartbeat)

Symptoms of Endocarditis


The symptoms of this disease vary from a person to person and change with time. In sub-acute Endocarditis, the symptoms slowly appear over a period of several weeks or months. However, in more serious condition, the symptoms appears abruptly.

So, this shows that the symptoms of Endocarditis vary individually depending upon the severity and causes of the condition. Some of these symptoms include:

  • Fever or high body temperature
  • Heart murmur
  • Muscle pain
  • Broken eye or skin blood vessels
  • Fingernails or toenails bleedings
  • Chest pain
  • Breathlessness
  • Headache
  • Coughing
  • Flat spots (that are painless) on the sole of the feet or palms.
  • Small nodules or lumps (which can be painful and have purple and red texture) on the fingers or toes
  • Sweating or night sweats
  • blood in the urine
  • swelling on lower limbs or abdomen
  • Weakness
  • Fatigue
  • Tiredness
  • Unexplained weight loss

Diagnosis of Endocarditis


To diagnose Endocarditis, doctors suggest some tests based on the patient’s symptoms and medical history which include:

  • Blood tests: The blood test help in identifying the bacteria into the bloodstream. It also helps in determining the underlying disease that can be a reason for Endocarditis
  • Echocardiogram: It helps in knowing the functioning or working of the heart with heart images created using sound waves
  • Erythrocyte Sedimentation Rate (ESR): In this type of test, doctors take the blood sample and measure how fast blood cells go down to the bottom of the tube. The faster the cells fall, there are more chances of Endocarditis. People suffering from Endocarditis have high ESR.
  • Electrocardiogram (ECG): It generally helps in determining the electrical activity of the heart.
  • Chest X-ray: This test also helps in viewing the heart and surroundings to find out the presence of pulmonary infection or an enlarged heart.
  • CT scan or MRI: It helps in determining the presence of infection and whether the infection affects other parts of the body or not.


Endocarditis is a heart infection that may be caused due to many reasons and affect heart and surrounding. The symptoms of this condition may vary from person to person. the best a person can do is to go for regular checkups, maintain oral hygiene, avoid harmful substances, etc. In cases, a person notices any of the above symptoms, it is always best to consult a doctor or professional healthcare.

FAQ About Endocarditis

Endocarditis is of two types:

  • Acute endocarditis
  • Subacute endocarditis

Acute endocarditis is a consequence of recent infection, whereas subacute endocarditis is a chronic disease. People suffering from subacute endocarditis might need additional monitoring.

The common indications and symptoms of endocarditis include:

  • Heart murmur
  • Chills
  • Fever 
  • Pale skin
  • Muscle pain
  • Night sweats
  • Joint pain
  • Nausea 
  • Weight loss
  • Loss of appetite
  • an enlarged spleen
  • Enlarged spleen
  • Coughing
  • Breathlessness
  • swollen feet, legs, or abdomen
  • blood in your urine

Endocarditis raises the risk of heart infection as it damages the heart tissues and valves. Some medical conditions can damage one or more of the heart valves. 

Patients at risk of developing endocarditis involve those who have:

  • Past bacterial endocarditis
  • Acquired valve disease 
  • Patients with devices, like pacemakers
  • An artificial heart valve, including bioprosthetic and homograft valves
  • Immune suppressed patients
  • Some congenital heart deformities
  • Hypertrophic cardiomyopathy (HCM)
  • Patients who are intravenous drug abusers

Endocarditis can be prevented in several ways, including:

  • Recognize the indications and symptoms of endocarditis. Consult a doctor immediately if you have any symptoms.
  • Give proper attention to dental health and get dental check ups regularly.
  • Avoid things that can lead to skin infections.


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