Endocarditis

Endocarditis usually happens when bacteria or fungus gets into your blood through your mouth or skin and travels to your heart.

This could be during a dental procedure or through a cut or graze, for example.

Anyone can get endocarditis, but it's more common in men and people over 50.

You have a higher risk of getting endocarditis if you:

• have heart valve disease, an artificial heart valve, or a pacemaker or implantable cardioverter defibrillator (ICD)
• have certain conditions, like some types of congenital heart disease or hypertrophic cardiomyopathy
• have had a heart transplant or endocarditis before
• work closely with farm animals
• inject illegal drugs

Symptoms of endocarditis may include:

• a high temperature, or feeling hot, cold or shivery
• headaches
• feeling very tired
• joint or muscle pain
• regularly sweating a lot during the night (night sweats)
• feeling breathless
• loss of appetite or losing weight without trying to

You may also have:

• small dark-coloured spots on your skin, or red spots on your palms or the soles of your feet (these may be less obvious on brown or black skin)
• small dark spots or dark lines under your fingernails
• small, painful lumps on your fingers or toes
• chest or back pain

The symptoms of endocarditis sometimes appear quickly over a few days but often come on slowly over weeks or months.

If you have symptoms of endocarditis, a doctor will examine you and listen to your chest. They'll ask about any recent dental treatment or other medical procedures you've had.

If the doctor thinks you may have endocarditis, you'll usually be referred to a heart specialist (cardiologist).

You'll have tests to:

• check for any bacteria or fungi that could have caused an infection
• see how your heart is working
• look for any signs of damage to your heart

These tests usually happen in hospital and may include:

• testing samples of your blood and pee
• a chest X-ray
• an electrocardiogram and echocardiogram
• an MRI scan

Treatment for endocarditis usually involves medicine and sometimes surgery.

Medicine for endocarditis

You'll be given antibiotic or antifungal medicine for 4 to 6 weeks to treat the infection.

This usually happens in hospital through a drip or injections into your vein (IV) to start with.

If you feel well enough and tests show the infection is under control, you may be able to finish having the IV medicine at home. A friend, family member, carer or district nurse may help with this, or you may be able to do it yourself.

Some people may need to continue taking medicine tablets for a few more weeks after the IV treatment has finished.

Surgery for endocarditis

Around half of people who have endocarditis will need surgery to remove or repair damaged heart tissue or valves.

Depending on where the infection is, you may also need to have a pacemaker fitted to keep your heart beating normally, or have your pacemaker removed and replaced if you already have one.

Endocarditis is a serious condition but many people fully recover, particularly if the infection is found and treated early.

It can take several months to feel completely better, especially if you had surgery. It's normal to feel very tired for several weeks after treatment.

You will need to have regular check-ups and blood tests during and after your recovery.

This is to make sure the infection has gone and to look for any signs of damage that could cause other complications, such as heart failure.

Having endocarditis increases your chance of having a stroke. Your doctor will talk to you about things you can do to lower your risk of stroke and any treatment you may need.

You also have a higher chance of getting endocarditis again, so it's important to know the symptoms and get help quickly if you think you may have it again.

If you're at higher risk of endocarditis, there are things you can do to lower your chance of getting it.

• take care of your teeth and gums and have regular dental check-ups – you may also be advised to speak to a doctor before having any dental procedures

• properly clean and cover any cuts and grazes to avoid getting infections

• wash your hands regularly

• make sure you and any family, friends or carers know the symptoms of endocarditis

• do not get any piercings or tattoos without speaking to a doctor first

Symptoms of endocarditis may include a high temperature, night sweats, feeling breathless, and small dark or red spots on your skin, palms or soles.

Endocarditis is usually treated with medicine in hospital to kill the infection. Some people may need surgery to fix or remove damaged heart tissue.

Many people recover fully from endocarditis but it can take a few months. Endocarditis increases the risk of stroke and can lead to heart failure.

Anyone can get endocarditis but it's more likely if you have a history of heart problems, work closely with farm animals or inject drugs.

Lower your risk of getting endocarditis by doing things like taking care of your teeth, treating cuts and grazes and regularly washing your hands.