Endocarditis Symptoms And What You Need To Know

Endocarditis, also known as infective endocarditis, typically develops in individuals who already have underlying heart conditions. It usually occurs after a bacterial infection, such as bacteremia or sepsis, which allows harmful microorganisms to reach the heart and infect the inner lining or valves. Recognizing the symptoms of endocarditis early is crucial for timely treatment and better outcomes.

Common Signs Of Infection

Fever is the most prominent symptom of infective endocarditis. It often persists for weeks and does not respond well to standard treatments, leading to a prolonged illness. Alongside fever, patients may experience fatigue, night sweats, chills, and a general loss of appetite. These signs are often mistaken for flu-like symptoms, which can delay diagnosis if not carefully evaluated by a medical professional.

Potential Embolic Complications

One of the more dangerous aspects of endocarditis is the risk of embolism. Infected material from the heart can break off and travel through the bloodstream, causing blockages in various organs. On the skin, small red or purple bumps called Osler's nodes may appear, often on the fingers or toes.

Organ-Specific Embolic Symptoms

• Spleen – Enlargement of the spleen, abdominal pain, and discomfort.
• Kidneys – Blood in the urine or changes in urination patterns.
• Digestive system – Blood in the stool or unexplained abdominal pain.
• Brain – Sudden headaches, nausea, confusion, seizures, or even coma if a cerebral artery becomes blocked.
• Lungs – Chest pain, shortness of breath, coughing, and potentially coughing up blood if a pulmonary artery is affected.

While pulmonary embolism can be life-threatening, the clots caused by endocarditis are usually smaller and less likely to cause sudden death compared to massive pulmonary embolisms.

Heart-Related Symptoms

Cardiac symptoms are among the most critical indicators of endocarditis. Patients may experience rapid or irregular heartbeats, shortness of breath, and sudden fatigue. A newly developed or changing heart murmur is often detected during a physical exam. These murmurs are typically loud and rough-sounding, especially when the infection affects the mitral valve.

Mitral Valve Involvement

If the infection affects the mitral valve, a systolic murmur can be heard clearly at the apex of the heart. This sound may be accompanied by a distinctive "seagull" noise, indicating the presence of vegetation on the valve. Sudden heart failure symptoms, such as difficulty lying flat, fluid retention, and reduced physical capacity, may also occur.

Aortic Valve Involvement

When the aortic valve is involved, the onset of heart failure can be rapid and severe. A sudden leak in the aortic valve due to infection can lead to dramatic changes in cardiac function. Echocardiography is a vital tool for detecting vegetations and assessing valve damage in suspected cases of endocarditis.