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Health Topic Of The Week: Endocarditis and Heart Health .

A common cause of infection of the lining of the heart valves and chambers is bacteria from the mouth…..Poor dental health can also increase the risk of developing endocarditis.

Source: (By Diana Rodriguez)

Normal Heart Valves

Normal Heart Valves

Medically reviewed by Lindsey Marcellin, MD, MPH

Heart Valve Infection

Infected Heart Valves

Endocarditis means inflammation of lining of the heart valves and heart chambers. There are two main types of endocarditis — infective endocarditis, and culture-negative endocarditis.

Infective endocarditis. This type is caused by bacteria (or sometimes fungi) in the bloodstream. It is most common in people with damage to a heart valve or who have a congenital heart disease. Typically, the bacteria that cause the infection come from the mouth or the skin. Endocardial infection occurs when these bacteria travel through the bloodstream and lodge in the heart lining.



Culture-negative endocarditis. This type is also caused by infectious microorganisms. However, the organisms that cause culture-negative endocarditis can’t be identified. It’s most common in people who have artificial heart valves, diseased heart valves, or congenital heart defects.

Endocarditis is not a common condition, affecting less than 30,000 people each year in the United States.

Symptoms of endocarditis include:

Flu-like symptoms like fever, aches, and pains
Feeling exhausted and weak
Problems breathing or feeling short of breath
Chills, sweating, and night sweats
Swollen legs or feet, or swelling in the abdominal area
Changes in urine color
Red lesions with no pain on the hands and feet
Painful red bumps in the toes and fingers
How Endocarditis Affects Heart Health

When the tissues inside the heart become inflamed from infection, a number of problems may result. Between one-third and one-half of people with infectious endocarditis will develop other heart conditions.

Problems that can ensue from endocarditis include:

Heart arrhythmias (irregular heartbeat) like atrial fibrillation
A blood clots forming in the heart
Heart murmurs, which may be heard by your doctor on physical exam
Congestive heart failure
Significant injury or damage to the heart valve
Heart attack
The Endocarditis-Teeth Connection

When you have a dental procedure, bacteria and other organisms in your mouth can get into your bloodstream. In fact, up to 50 percent of all cases of infectious endocarditis stem from bacteria found inside the mouth. For the vast majority of people, dental work is not a problem, because the immune system can take care of these before they cause any heart damage. But for people with artificial heart valves or other risk factors for endocarditis, mouth bacteria can make a beeline for the lining of the heart, causing inflammation.

Poor dental health can also increase the risk of developing endocarditis. If gums are inflamed and diseased, even just brushing your teeth increases the risk that bacteria will enter the bloodstream. In fact, experts believe that if you have risk factors for endocarditis, you are more likely to have bacteria enter your bloodstream from brushing your teeth than from having dental work done.

Other causes of bacteria entering the bloodstream and causing endocarditis include normal skin bacteria entering through a skin break, particularly through needlesticks in intravenous drug abusers.

Previously it was thought infectious organisms causing endocarditis might also get into the bloodstream during medical procedures involving the respiratory, gastrointestinal, and genitourinary tracts, because these areas are usually contaminated with bacteria. But it’s now believed that such procedures are not a common cause of endocarditis.

Diagnosing and Treating Endocarditis

Endocarditis can be diagnosed though blood cultures that look for bacteria in the blood and tests that can image the heart valves, such as an echocardiogram.

The first line of treatment for endocarditis is typically a round of intravenous antibiotics, administered in the hospital. Treatment can last for up to six weeks to get rid of the infection.

Sometimes, in the case of a damaged heart valve, surgery may be needed to repair or replace the heart valve.

Endocarditis Risk Prevention

People who are at very high risk for endocarditis should consider taking an appropriate antibiotic before undergoing any routine dental work. High risk conditions include:

Having a previous history of endocarditis
Having an artificial heart valve
Having certain kinds of congenital heart defects
Having had a heart transplant, with heart valve damage after the surgery
It is no longer recommended that you get preventative antibiotics before dental work simply because you have a heart murmur. Discuss this ahead of time with both your medical doctor and your dentist if you are unsure of your risk category.

Practicing good dental hygiene — regular dental checkups, and frequent brushing and flossing — can help reduce the risk of tooth decay and gum disease, and therefore also reduce the risk of endocarditis

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