Endocarditis (bacterial infection) cardiology

Endocarditis and its overview

Did you know that the walls of your heart are made up of three layers?  The outer layer is called the epicardium, the middle layer is the myocardium, and the innermost layer is the endocardium. 

Inflammation of this innermost layer and of your heart valves is called endocarditis. Endocarditis is usually caused by a bacterial infection. Bacteria enter your bloodstream from another part of your body and attach to damaged areas in your heart.  Because of this, you are more likely to develop endocarditis if you already have a damaged or artificial heart valve.

Use this condition center to learn more about endocarditis. You can keep up with the latest research, find questions to ask your doctor, and get tips to help you feel your best.


Endocarditis is an infection of the inner lining of the heart. It is typically caused by bacteria (or in rare cases fungi) from other parts of your body, for example your mouth or skin. These bacteria travel through the bloodstream and can attach to the inner surface of the heart where an infection can grow. If left untreated, the infection not only damages the heart valves and heart lining, but it can spread to other areas of the body and even cause a stroke.

Endocarditis is more common in people who have an artificial heart valve or pacemaker, and in those who had heart defects from birth that have been repaired with surgery.  Endocarditis also is more common in people whose immune systems are weak, those on dialysis and those who use injected drugs.

Treatment includes a long course of antibiotics. Some people require heart surgery to remove the infection and repair the damage.

Individuals who have had endocarditis once are more likely to have it a second time. Also, they may need antibiotics before having dental treatments and other medical procedures to lower the risk of infection and getting endocarditis.

Signs and Symptoms

The most common symptoms of Endocarditis are:

  • Fever
  • Chills
  • Sweats
  • General malaise

Your doctor also may identify a new or worsening heart murmur. If your heart valve is significantly affected, you may have shortness of breath and other symptoms of congestive heart failure .

Endocarditis involving valves on the left side the heart (aortic and mitral valves) may cause a stroke. This can occur if parts of the infection break off the valve and travel to the brain. Signs and symptoms of stroke  include a sudden change in vision, speech, movement, or consciousness.  

Some patients have with symptoms that have gone on for a while or that are vague. This is called “subacute” endocarditis.

Other signs and symptoms include dark marks on the palms and soles, or painful red marks on the hands and feet.

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