What are the symptoms of endocarditis?

Endocarditis, or infective endocarditis, is a condition that occurs when the inner lining of the heart (the endocardium) or the heart’s valves become infected by bacteria or other germs. Endocarditis is typically caused by bacteria that spread through the bloodstream from the mouth, from infected foreign bodies such as needles, or from another part of the body to the heart. Endocarditis is more likely to affect those who have a previously damaged heart valve, an artificial heart valve, other heart disease, or congenital defects (heart defects that are present at birth). It can occur in people with otherwise healthy hearts as well. 

Symptoms of endocarditis include:

• Persistent or recurring high fever 
• Fatigue and shortness of breath
• Skin rash

Possible warning signs include weakness, fatigue, a slight fever, aching joints, and appearance of new, tiny dot like areas on the back, chest, fingers, and toes. There is often a heart murmur indicating an abnormal valve or other heart defect. An eye exam may show small hemorrhages in the mucous membranes. In some cases, the disease comes on suddenly, with high fever, shaking, chills, and rapid destruction of the involved heart valve.

Most people with endocarditis have symptoms that begin within 2 weeks after becoming infected. Vague, flu-like symptoms, such as a low-grade fever and fatigue, often occur first. But infection with a powerful strain of bacteria may cause symptoms to be more severe (such as a high fever) and to appear much faster, within a few days. If symptoms persist, see your doctor, especially if you are at a high risk for endocarditis.

Symptoms include:

• Chills and fever
• Fatigue
• Weight loss
• Night sweats
• Painful joints
• Persistent cough and shortness of breath
• Bleeding under the fingernails
• Tiny purple and red spots under the skin

If you have certain heart conditions, getting endocarditis is even more dangerous for you. These heart conditions include:

• Artificial heart valves
• Endocarditis in the past
• Heart defects since birth (congenital heart defects)
• Heart valve problems after a heart transplant

Other risk factors (things that raise your risk) for endocarditis include:

• Having hypertrophic cardiomyopathy.
• Having hemodialysis, which is a treatment to clean the blood for people who have kidney failure.
• Injecting street drugs using dirty needles or without cleaning the skin.
• Having HIV, which can reduce your ability to fight infection.

Your doctor can tell you whether you are at increased risk for endocarditis. Before you have any medical, dental or surgical procedures, tell all other health professionals who may treat you that you are at risk for endocarditis. Your doctor can give you a card to carry in your wallet stating that you may need preventive antibiotics before having certain procedures.

Complications

You will likely have symptoms if you have a complication of endocarditis. Complications may include:

• Heart failure.
• Abscesses in the heart.
• Heart rhythm problems.
• Heart attack.
• Stroke.
• Infections in other organs such as the lungs, brain or kidneys.