Infective Endocarditis: What You Need To Know
June 17, 2021 | Farah Jassawalla

Infective Endocarditis: What You Need To Know

Endocarditis is a rare medical condition. It is characterized by the inflammation of the heart valves and the endocardium. It occurs when bacteria move into the blood circulation and attack the heart’s lining. This is why it is also known as infective or bacterial endocarditis. Infective endocarditis should not be left untreated because it can cause permanent damage and eventually death.

Endocarditis can be acute or chronic, depending upon the state of the disease. Acute endocarditis develops rapidly within days, while chronic endocarditis takes months or weeks to develop.

Who is at risk of developing endocarditis?

Studies have revealed that it occurs more commonly in men than in women. It is also prevalent in people with weaker immune systems and in those who have conditions like:

      Damaged heart valves

      Cardiomyopathy (Enlargement of the heart muscle)

      Narrowing of heart valves

Causes of infective endocarditis

Normally, your immune system destroys harmful organisms and prevents them from causing any serious problems within your body. But when microorganisms bypass your immune system, they tend to cause many dysfunctions, endocarditis being one of them.

Bacteria such as Streptococcus and Staphylococcus aureus are the main agents behind this infection. Other causative agents include:


      Streptococcus Bovis

      Viridian streptococcus

      Coagulase-negative staphylococci

      Haemophilus influenzae


Factors that lead to infective endocarditis are:

      Drug addiction

      Artificial heart valve

      Improper dental hygiene

      Previous infective endocarditis

      Impaired immune system

      Abnormal heart valve due to valve replacement surgery

      Heart defect by birth

      Chlamydia and gonorrhea (sexually transmitted infections)

      Intestinal disorders

      Implanted devices such as pacemakers

Symptoms of infective endocarditis

Here is a list of the most common symptoms of infective endocarditis.




      Skin rash






      Chest pain

      Blood in urine

      Unusual heart sounds

      Pain in joints and muscles

      Shortness of breath

      Unhealed cuts

      Swollen legs, feet, and abdomen

      Splinter hemorrhages

      Difficulty in swallowing

      Osler nodes (fingers and toes having painful nodes)

How is bacterial endocarditis diagnosed?

Bacterial endocarditis can be diagnosed in several ways.

1.    Complete blood count.

2.    CT scan: It shows whether the bacteria has affected your brain or chest.

3.    X-ray: It shows if the bacteria has affected your lungs or not.

4.    C reactive protein.

5.    Endocardiogram: It shows abscesses, holes, or any kind of growth on heart valves.

6.    Blood cultures.

7.    Erythrocyte sedimentation rate: In this diagnostic test, a test tube is filled with liquid. Next, the blood cells are introduced into the tube. The speed with which the blood cells fall to the bottom is directly proportional to the incidence of an inflammatory condition, such as endocarditis.

How is bacterial endocarditis treated?

Your treatment options for endocarditis include long-term antibiotic therapy and surgery.

Long-term antibiotic therapy:

      Blood samples are taken before prescribing.

      Antibiotics such as vancomycin or ampicillin/sulbactam and an aminoglycoside are prescribed. For medications, you can book an online appointment at Shifa4U.

      If the patient has prosthetic valves, then rifampin is also added to the treatment regimen.

      Therapy extends from 4 to 6 weeks.


It is reserved for chronic endocarditis. Surgery is the choice of treatment when:

      The patient experiences a stroke.

      There are large lumps or abscesses within the lining of the heart.

      The patient doesn’t respond to antibiotics or antifungal treatment.

      Blood starts flowing back to the heart.

      More than one blood clot is present.

      The patient has an ongoing high fever.

Farah Jassawalla

Farah Jassawalla is a graduate of the Lahore School of Economics. She is also a writer, and healthcare enthusiast, having closely observed case studies while working with Lahore's thriving general physicians at their clinics.