Cardiovascular Diseases





Endocarditis is an infection of the endocardium (the inner lining of the heart), the heart valves, or the aorta (the large vessel through which blood leaves the heart). This infection is most often caused by a bacteria that is normally found in certain areas of the body, such as the mouth, the digestive tract and skin, or that has caused an infection somewhere else in the body and that enters the bloodstream and becomes lodged in the heart. This type of infection can damage and even destroy the heart valves. Endocarditis is a rare but very serious disease. It requires long-term antibiotic treatment at the hospital and sometimes emergency surgery.

Causes and/or risk factors 

Healthy people have a low chance of developing endocarditis. However, people with certain heart diseases are at a higher risk of a bacterial infection in the heart. People are at risk if they have:

  • An artificial valve
  • A history of endocarditis
  • Cyanotic heart disease (abnormally low blood oxygen levels due to a heart defect)
  • A heart defect that has been repaired with artificial material (the first six months after the procedure), e.g., closure of an atrial septal defect (ASD) or ventricular septal defect (VSD)
  • A residual problem at the site of a heart defect repair, e.g., residual VSD after a closure
  • A valve problem that develops after a heart transplant

    Some procedures promote the entry of bacteria into the bloodstream and are associated with the risk of endocarditis:

    • Dental procedures
    • Gastrointestinal and urinary procedures in patients who have an infection
    • Respiratory procedures involving an incision or biopsy

    Certain situations are also associated with a risk of endocarditis: skin infections, furuncles (boils), infected cuts, infected acne, or any condition that produces pus.


The symptoms of endocarditis are similar to those of a severe case of persistent flu. Patients generally have a fever (oral temperature > 38 °C). This fever may be accompanied by fatigue, chills, joint pain, excessive sweating, shortness of breath and headaches.


After filling out a comprehensive questionnaire and performing a physical exam, the doctor will prescribe certain tests or exams to diagnose the disease if he or she suspects endocarditis:

  • Blood tests (to screen for the presence of bacteria)
  • Transthoracic and/or transesophageal echocardiography

If you are at risk:

  • It is important to advise all of your treating doctors that you are at risk of developing endocarditis.
  • Poor dental hygiene can also promote the entry of bacteria into the bloodstream. It is therefore important that you brush your teeth frequently and keep up with your regular dental checkups.
  • If you have to have surgery, it is important to advise the surgeon that antibiotics are usually necessary prior to your dental checkups. The surgeon will then decide if antibiotics are necessary before the operation.

Patients who develop endocarditis must be hospitalized and receive IV antibiotics for a period of 4 to 6 weeks. Heart surgery is sometimes necessary to treat a damaged valve or other complications.