The endocardium is the inner lining of the heart muscle. Endocarditis is an infection of this lining and the heart valves.


Causes of endocarditis include:

  • Bacterial infection —the most common cause
  • Viral or fungal infection
  • Medical conditions that result in blood clotting too easily, causing a noninfectious form
  • Bacterial Endocarditis

    Nuclus factsheet image

    Copyright © Nucleus Medical Media, Inc.

    Risk Factors

    Factors that may increase your risk of endocarditis include:

  • Having an artificial heart valve
  • History of endocarditis
  • 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
  • Symptoms

    Symptoms of endocarditis 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
  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will check your heart for unusual heart sounds. These are called heart murmurs .

    Tests include:

  • Blood tests
  • Echocardiogram
  • Treatment

    Treatment may include:

  • Antibiotics—given by IV for up to 4-8 weeks
  • Surgery—to repair or replace the valve if it is severely damaged or has caused heart failure
  • Prevention

    If you have a high risk of infection:

  • You may need to take antibiotics before certain dental or medical procedures.
  • Talk to your dentist or doctor before the procedure.
  • The American Heart Association guidelines recommend that preventive antibiotic therapy should be considered for individuals with the following cardiac conditions:

  • Various forms of congenital heart defects
  • Artificial heart valves
  • History of endocarditis
  • Heart transplant recipients who have developed valve disease
  • Avoiding illicit IV drugs will also decrease your risk of infection.