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When the inner lining of the heart muscle, or endocardium, becomes infected it’s referred to as endocarditis. This life-threatening illness is rare, but can usually be treated by antibiotics. Sometimes surgery is necessary.

Treating Endocarditis at UVA Health

If it's caused by a bacteria, then you’ll be given antibiotics. Because of the severity of the location, generally you'll be treated with high doses of intravenous antibiotics. This will mean spending a week or more in the hospital so that we can make sure the treatment is working.

If damage has been done to the valves of the heart, surgery may be necessary. Mitral valve repair surgery is the most common procedure.

If your endocarditis is caused by a fungal infection, then surgery may also be necessary.

What Causes Endocarditis?

There are several potential causes of endocarditis. But by far the most common cause is a bacterial infection. When the inflammation is caused by bacteria, it’s sometimes called infective endocarditis (IE).

This infection can also be caused by a fungal infection or a virus. Rarely, there’s no explanation for how it started. Recently, endocarditis has emerged as a complication of COVID-19.

Risk Factors

Anything that causes damage to your heart valve increases your risk of endocarditis. Other major risk factors include recent surgeries that may have introduced bacteria into your system. 

Factors that may increase your risk include:

  • Having an artificial heart valve
  • History of rheumatic fever, which can damage heart valves
  • Heart defects
  • Enlarged heart
  • Mitral valve prolapse
  • History of IV drug use
  • Recent procedures that can lead to bacterial endocarditis, including:
    • Tooth cleaning
    • Tonsillectomy and adenoidectomy
    • Bronchoscopy
    • Surgery on the gastrointestinal, urinary or respiratory tracts
    • Gallbladder or prostate surgery
  • Being over the age of 60
  • A weakened immune system, due to a health condition like HIV or certain treatments, like chemotherapy. 

Symptoms of Endocarditis

While most of the symptoms of endocarditis are non-specific flu-like symptoms, some are more telling. If you have painful red or purple bumps on your fingers and/or toes, for example.

If you have any of these symptoms following an event that’s a risk factor, like surgery, it’s important to call your doctor as soon as possible. 

Symptoms include:

  • Fever, chills
  • Weakness, low energy
  • Sweatiness, especially at night
  • Shortness of breath
  • Cough
  • Loss of appetite, weight loss
  • Chest pain
  • Abdominal pain
  • Nausea and vomiting
  • Painful red bumps on the fingers and toes
  • Purple dots on the whites of the eyes, under the fingernails and over the collarbone
  • Painful red patches on the fingers, palms and soles

How Is It Diagnosed?

Your doctor will check your heart for any sounds of murmurs. Based on what they hear, they may decide to run blood tests.

Some other tests that may be necessary include: