Endocarditits

Endocarditits

Learning About Endocarditis

What is endocarditis?

Endocarditis (say "en-doh-kar-DY-tus") is an infection of the heart's valves or inner lining (endocardium). It is usually caused by bacteria, but it also can be caused by fungi. The bacteria or fungi get into the bloodstream and settle and grow on the inside of the heart, usually on the heart valves. Bacteria or fungi can enter the bloodstream in many ways, including through some dental and medical procedures.

Endocarditis can damage your heart. You need to treat it as soon as possible.

People who have a normal heart are not likely to get endocarditis. But some people are more likely to get endocarditis than others. This includes people who have a heart problem that affects normal blood flow, such as a heart valve problem, or people who inject illegal drugs.

For some people, endocarditis may be serious and is even more dangerous. These people are those who:

• Have an artificial heart valve.
• Have had endocarditis before.
• Have had certain heart problems since birth (a congenital heart problem).
• Have heart valve problems after a heart transplant.

What are the symptoms?

Flu-like symptoms, such as a mild fever and feeling tired, often occur first. Other symptoms may include weight loss, night sweats, and painful joints.

You may not think these symptoms are cause for worry. But if you are at risk for endocarditis or the symptoms do not go away, contact your doctor.

How can you prevent endocarditis?

• If you are likely to get endocarditis, floss your teeth daily, and visit a dentist twice each year. Make sure your dentist knows that you are at risk for endocarditis.
• You may need to take antibiotics before certain dental and medical procedures if you:
• Have an artificial heart valve.
• Have had endocarditis before.
• Have had certain heart problems since birth.
• Have heart valve problems after a heart transplant.

Ask your doctor or dentist whether you need antibiotics to prevent endocarditis and which procedures you may need them for.

Your doctor may give you a card to carry in your wallet that states that you may need preventive antibiotics before certain procedures.

How is it treated?

Treatment for endocarditis may include:

• Antibiotics or antifungal medicine given through a vein (intravenously, or by IV).
• Antibiotics taken by mouth after IV antibiotics.
• Surgery to repair or replace heart valves.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Learning About Dental Care and Your Health Problem

What special care may be needed before dental work?

When a dentist works on your teeth, or even if you are just having your teeth cleaned, you can get tiny cuts in your gums. For most people this isn't a problem. But it can be serious for people with certain health conditions.

Some people need to take antibiotics before certain types of dental work.

People who take a daily low-dose aspirin may need to stop taking it a few days before dental work.

People who take certain other medicines should make sure their dentist or hygienist knows about those medicines before any dental work starts.

Who needs to take special care?

You may need to take precautions before dental work if you:

• Have had a hip, knee, or shoulder replacement. Infections can spread from other parts of the body, such as the mouth, to the artificial joint and cause a serious problem. Your doctor may recommend that you take antibiotics before and after the dental work to reduce the risk of infection.
• Have had an organ transplant. Tell your dentist that you have had a transplant. It is always important to keep your gums and teeth clean and healthy, but it is especially true after a transplant. The antirejection medicines may increase your risk of mouth infections.
• Have certain heart problems. You may have a higher risk of dental work causing infection in your heart. Talk to your doctor about whether you need to take antibiotics before certain kinds of dental work if you:
• Have an artificial heart valve.
• Have had endocarditis.
• Have had heart defects since birth.
• Have had heart valve problems after a heart transplant.
• Are taking low-dose aspirin every day. You may need to stop taking aspirin at least 5 days before dental work that may cause bleeding.
• Are taking warfarin. The medicine may cause you to bleed more than is usual during certain types of dental work. Your dentist needs to be prepared for this possibility.

How can you prevent problems?

• Always let your dentist know if:
• You are taking warfarin or a daily low-dose aspirin.
• You have had surgery to get an artificial joint.
• You have had heart surgery.
• You have had other major surgery.
• If you expect to have surgery and you also need major dental work, tell your doctor. He or she may recommend that you have the dental work done before the other surgery.

Bacterial Endocarditis: After Your Visit

Your Care Instructions

Bacterial endocarditis (say "en-doh-kar-DY-tus") is an infection of the heart valves. It is caused by bacteria that enter the bloodstream and settle on one or more of the heart valves. This can damage the valves. In some cases, surgery is needed to replace a damaged valve.

Antibiotics can cure bacterial endocarditis. But now that you have had the infection, you are at risk for getting it again. It is important that you let all your other health professionals—including your dentist—know that you have had bacterial endocarditis.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• If you are taking IV antibiotics at home with the help of a home health nurse, the nurse will teach you how to use the antibiotics and how to care for your IV catheter. Make sure you are comfortable using and caring for the IV.
• If your doctor prescribed antibiotic pills, take them exactly as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• In the future, you may have to take antibiotics before certain medical, dental, or surgical procedures. Ask your doctor or dentist about this, and do not have any of these procedures without talking to your doctor or dentist first. Your doctor can give you a card to carry in your wallet which states that you need preventive antibiotics before certain procedures.
• Practice good oral hygiene by flossing your teeth daily and by visiting a dentist twice each year. Make sure your dentist knows that you have had endocarditis.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You have symptoms of a heart attack. These may include:
• Chest pain or pressure, or a strange feeling in the chest.
• Sweating.
• Shortness of breath.
• Nausea or vomiting.
• Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
• Lightheadedness or sudden weakness.
• A fast or irregular heartbeat.

After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.

• You have severe trouble breathing.
• You cough up pink, foamy mucus and you have trouble breathing.
• You passed out (lost consciousness).

Call your doctor now or seek immediate medical care if:

• You have new or increased shortness of breath.
• You are dizzy or lightheaded, or you feel like you may faint.
• You have a new or higher fever.
• You have a fast or irregular heartbeat.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You develop a new rash or changes in your fingernails.
• You start to feel like you did when you first got sick.
• You do not get better as expected.