Infective Endocarditis

​Infective Endocarditis

When bacteria enter the bloodstream, it’s serious. When infection takes hold inside the heart and heart valves, it’s critical – sometimes requiring emergency medical care.

Treating infective endocarditis requires swift action and a specialized expertise. The Christ Hospital Heart & Vascular Institute has everything it takes to treat infective endocarditis right here in Greater Cincinnati so you don’t have to seek care outside the region.

If you suspect you or a patient has infective endocarditis, call Greater Cincinnati’s Heart Hospital at 513.206.1170 for an appointment. We can also offer second opinion consultations if you have been diagnosed with endocarditis and told you may not be a candidate for surgery.

What is infective endocarditis?

Endocarditis is an inflammation of the lining of your heart valves and surface of its valves (endocardium). Infective endocarditis is inflammation caused by an infection, which is usually bacterial, but sometimes caused by fungi. It is usually caused by bacteria that reaches your heart via the blood stream from other parts of your body.

The two most common infections to impact heart valves are strep and staff infections, but other bacteria can also be the cause. Failure to quickly treat infective endocarditis can cause permanent damage to your heart and can even be fatal.

Complications from infective endocarditis can include heart failure, damage to the heart valves, blood clots, stroke, damage to other organs including the kidneys, brain, and lungs.

Risk factors for infective endocarditis

Bacteria are always present in your body and sometimes enter the blood stream. When bacteria gets into the blood stream, you are at increased risk for infective endocarditis if you:

  • Have congenital heart disease

  • Have been previously diagnosed with infective endocarditis

  • Have existing damage to or enlarged heart valves

  • Have had previous heart valve surgery

  • Have an artificial heart valve or other implanted devices such as a pacemaker or aortic graft

In addition to these risk factors, you are at increased risk of bacteria entering your blood stream if you are an intravenous drug user, have a prolonged exposure to a catheter, have poor dental hygiene or have had recent dental surgery that required cutting into the gums. Poor dental hygiene also increases your risk.

If you meet the risk factors for infective endocarditis and are experiencing symptoms, you may require emergency medical care.

Symptoms and diagnosis of infective endocarditis

While symptoms can vary depending on factors such as the type of infection or pre-existing conditions, the most common symptoms of infective endocarditis include:

  • Flu-like symptoms such as fever, chills, and fatigue

  • Night sweats

  • Aching in joints and muscles

  • Unexplained weight loss

  • Heart murmurs

  • Chest pain when breathing

  • Shortness of breath

  • Swelling in the abdomen, legs and feet

  • Unexplained changes to the skin

Blood tests are required to determine if bacteria is present in your blood stream. These tests can also indicate a lack of red blood cells – another sign of infective endocarditis. An echocardiogram will also be used to show inflammation and any damage to the heart. Other imaging such as an electrocardiogram, X-ray or MRI may be needed to detect further damage to the heart or other areas of the body. Diagnostic testing can also detect infections to implanted devices such as an artificial valve, pacemaker or aortic graft.

Symptoms and illness from infective carditis can be noticeable as soon as 48 to 72 hours from the onset of the infection but can also increase and become noticeable over time.

Treatment for infective endocaditis

Treating infective endocarditis requires antibiotics to rid the heart or implanted devices of the infection. Antibiotics are often administered through an IV which requires a hospital stay. This also allows for round-the-clock monitoring during the early stages of treatment when the risk of complications is higher. It can take 2-6 weeks for antibiotics to rid your body of the infection.

In some cases, surgery is required to repair damage to the heart or to remove infection when antibiotics are not working. Surgery is often required in the event of fungal infections as antifungal medications are not effective in treating infections in the heart. Surgery is also required for patients with artificial valves or other implants that get infected.

Why choose The Christ Hospital for treatment of infective endocarditis?

Due to the complex nature of the disease, the team at The Christ Hospital takes a multidisciplinary approach to treating infective endocarditis. The endocarditis team is led by Thoracic and Cardiac Surgeon J. Michael Smith, MD, who works with providers from multiple disciplines throughout The Christ Hospital Network including:

  • Experts from The Christ Hospital Heart & Vascular Institute who provide diagnosis, monitoring and valve repair or replacement when needed. Heart failure specialists may also be involved in cases of heart failure brought on by infective endocarditis.

  • Infectious Disease specialists who diagnose and treat the infections that cause the inflammation. They collaborate with the hospital pharmacy staff to administer the appropriate treatment for each respective type of infection.

  • Neurosurgeons and Neurologist who provide treatment in the event of specific complications such as stroke.

  • Hospitalists who provide around-the-clock care from a physician during inpatient treatment.

Infective endocarditis can be caused by bacteria introduced to the body via intravenous drug use. The Endocarditis team at The Christ Hospital Health Network is committed to improving the health of all patients and promoting sustainable long-term recovery. That’s why our team also includes experts who work with the patient to treat the root cause and help prevent future occurrences. These experts include:

  • Social workers who help patients gain access to treatment and services they need to improve their emotional and physical health, as well as navigate the journey of treatment and recovery.

  • Licensed drug and alcohol counselors to help patients manage and overcome addiction issues.

  • Attending psychiatrists to help patients understand and cope with mental health concerns surrounding addiction. Hospital chaplains are also available to provide emotional and spiritual support to patients of all faiths.

Appointments and second opinions

In most instances, patients with infective endocarditis come to us via physician referral or are transferred from another hospital. However, if you have been diagnosed but are told that you are not a candidate for surgery and would like a second opinion, you can call for an appointment. You can be evaluated by our multidisciplinary team with expertise on diagnosis and treatment of endocarditis.

To refer or transfer a patient, or if you are a patient seeking a second opinion, call The Christ Hospital Heart & Vascular Institute at 513.206.1170.