Endocarditis

Inflammation of the endocardium (the membrane that lines the inside of the heart), particularly of the heart valves. Endocarditis is most often due to infection with bacteria, fungi, or other microorganisms, which may be introduced into the bloodstream during surgery or by intravenous injection with dirty needles. People whose endocardium has previously been damaged by disease are particularly vulnerable to endocarditis, as are intravenous drug users and people whose immune system is suppressed. Endocarditis is also a rare feature of some types of cancer. Endocarditis may be either subacute or acute. In the subacute form, symptoms are general and nonspecific, although serious damage may be caused to a heart valve; the sufferer may complain of fatigue, feverishness, and vague aches and pains. On physical examination, the only evident abnormality may be a heart murmur. Acute endocarditis, which occurs less frequently, comes on suddenly, and causes severe chills, high fever, shortness of breath, and rapid or irregular heartbeat. The infection progresses quickly and may destroy the heart valves, leading to heart failure. Endocarditis is diagnosed by physical examination and analysis of blood samples. Tests on the heart may include ECG, echocardiography, and angiography. Treatment is with high doses of antibiotic drugs, which are usually given intravenously. Heart-valve surgery may be needed to replace a damaged valve.