Endocarditis (infective endocarditis)

Heart information sheets

What is infective endocarditis? Infective endocarditis is a rare condition where the inner lining of the heart most commonly one of the heart valves becomes infected. It affects fewer than 10 in 100000 people a year in the UK. Most of these people already have some form of abnormality in the structure of the heart. Infective endocarditis is a serious condition, which can be life-threatening if not treated quickly. If diagnosed early enough, most people recover well with antibiotic treatment, although the infection may cause some damage to the heart valves. If this happens, surgery may be needed to repair or replace the valve. Who is most at risk of developing endocarditis? The people who are most at risk of endocarditis are those who have: a leaking or stiff heart valve a heart valve replacement hypertrophic cardiomyopathy most types of congenital heart disease including conditions where the heart disease has been treated or repaired with surgery (but there are some exceptions to this see Who is not at risk of developing endocarditis below). intravenous drug users people who have already had infective endocarditis Who is not at risk of developing endocarditis? The people who are not at risk of developing endocarditis are those people who have: certain types of congenital heart disease - atrial septal defect (on its own), repaired ventricular septal defect and repaired patent ductus arteriosus a pacemaker or ICD (internal cardioverter defibrillator) previous bypass surgery a stent to treat angina

Endocarditis in people who have entirely normal hearts is extremely rare. What causes infective endocarditis? It is caused by a bacterium or, in some rare cases, another type of infective organism that is in the bloodstream and which settles onto the abnormal structure or defect in the heart. Although it is not possible to prevent all bacteria from getting into the bloodstream, there are some things you can do to reduce the risk of getting endocarditis. maintain good oral hygiene (teeth and gums) and have regular check-ups with your dentist. avoid body piercing or tattooing. dont inject recreational drugs.

Advice for people who are at risk of endocarditis Up until very recently, people at risk of endocarditis were advised to take antibiotics before having dental treatment and some other forms of treatment. The National Institute for Health and Clinical Excellence (NICE) is the organisation that provides advice on promoting good health and preventing and treating illnesses. It recently looked at all the latest relevant research and concluded that it is very unlikely that there is any overall benefit from taking antibiotics before having dental treatment or certain other procedures. In other words, taking antibiotics before having dental treatment or other tests will not reduce your risk of developing endocarditis. Bacterial resistance to antibiotics is also increasing, making them less effective. For more information please visit the National Institute for Health and Clinical Excellence (NICE) website www.nice.org.uk reference CG64 What are the symptoms of infective endocarditis? One of the reasons why infective endocarditis is so dangerous is that the early symptoms are often very subtle and non-specific. If you are at high risk of getting endocarditis and you have flu-like symptoms with

Endocarditis (infective endocarditis)

Heart information sheets

a high temperature that lasts for longer than a week, you should see a specialist. Make sure that your specialist and GP knows that you are at increased risk of getting endocarditis. If you know that you are at increased risk of developing infective endocarditis, you should carry an endocarditis warning card to show to your GP and to any other health professionals who may need to give you treatment. You can get one from the British Heart Foundation by calling the Heart HelpLine on 0300 330 3311 or our Orderline on 0870 600 6566. How is it diagnosed? Infective endocarditis is diagnosed by looking for clinical signs of the disease such as a high temperature, or a new or changing heart murmur and taking blood tests, called blood cultures, to find out if there are bacteria in the bloodstream. Echocardiograms are useful, both to help to confirm a diagnosis, and to assess the heart as treatment progresses. What is the treatment for infective endocarditis? If you develop infective endocarditis, you will need to go into hospital to have intravenous antibiotics (antibiotics given through a vein). How long you have to stay in hospital for this treatment will depend on how severe your infection is and on the type of antibiotics needed to treat the infection. It is likely you will need to continue taking antibiotic tablets at home for a further few weeks. If the infection does not respond well to the antibiotics, or if a valve becomes badly damaged as a result of the infection, you may need to have surgery.

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This information is not intended to substitute the advice that your doctor or specialist can give you British Heart Foundation 2012, registered charity number in England and Wales (225971) and in Scotland (SC039426)