Bacterial Endocarditis

Overview

What is bacterial endocarditis?

Bacterial endocarditis (BE) is an infection of the valves and inner lining of the heart (called the endocardium). It happens when bacteria from the skin, mouth, intestines or urinary tract enter the bloodstream (usually during a dental or medical procedure) and infect the heart.

Causes

Who gets bacterial endocarditis?

Although BE can occur in anyone, people who already have a diagnosed heart valve problem, an artificial valve or a heart defect are at greatest risk. Having a heart murmur sometimes increases the chances of getting BE. Your doctor can usually determine whether you have a type of heart murmur that increases your risk of BE.

Do medical and dental procedures increase the risk of BE?

If you have a heart defect or valve problem, dental work (including professional teeth cleaning) and some medical procedures (such as colonoscopy, cysoscopy and sigmoidoscopy) can increase the risk of bacteria entering the bloodstream.

Diagnosis

How can you tell if you have BE?

Fever, chills and other flu-like symptoms may be the only signs of BE. Other symptoms are unexplained weight loss and weakness. Your doctor may suspect you have BE if he or she hears abnormal heart sounds with a stethoscope. Your doctor will then need to do more tests, such as blood tests and echocardiography (looking at the heart by using ultrasound) to find out if you have BE.

Prevention

Can BE be prevented?

If you have a heart defect or valve problem, be sure to inform your doctor or dentist. If you plan to have your teeth cleaned or have another one of the procedures that increases your risk for BE, you may need antibiotics prior to the procedure. The antibiotics can help keep bacteria from surviving in your bloodstream. Check with your doctor to see if you require antibiotics before a dental or surgical procedure.

Treatment

How is BE treated?

BE is treated with antibiotics. Antibiotics are usually started intravenously (through an IV) in the hospital, but many people can finish their treatment at home. For more complicated infections, heart surgery may be needed.

Complications

Are there complications of BE?

Once infected, your heart may not pump blood as well as it did before. This is called heart failure. Other problems include irregularities of the heartbeat, damage to the heart muscle and blood clots. If BE isn’t treated, it can lead to death.

Questions to Ask Your Doctor

  • Am I at risk for bacterial endocarditis?
  • How can I make sure that health care workers and my dentist know about my risk for BE?
  • Do I need to take antibiotics? How should I take them?
  • Will antibiotics interact with any of the other medicine(s) I currently take?
  • Does bacterial endocarditis increase my risk for other long-term health problems?

Citations