Last updated: Jun 3, 2025Published on: Jun 3, 2025
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Introduction
As you may already know, the heart is one of the most important organs in the body. It helps supply and circulate blood to all parts of the body and is central to human survival. Just like how sometimes we get a throat infection or a stomach bug, did you know that the heart can also get infected in the same way?
Endocarditis is an infection of the heart where the inner lining of the heart gets inflamed. Endocarditis treatment is usually administered almost immediately to prevent further complications. Endocarditis can be life-threatening if not diagnosed and treated quickly.
Being diagnosed with a heart condition can be daunting, however, gaining awareness and knowledge about the condition can help you take the right steps towards your treatment and recovery. Read on to know all about the symptoms, causes and endocarditis treatment in India in this comprehensive guide.
What is Infective Endocarditis?
Infective endocarditis, or bacterial endocarditis, is a condition where the inner lining of your heart’s valves and chambers, known as the endocardium, gets inflamed due to an infection (usually bacterial, but can be fungal as well)1.
How does it occur?
It usually occurs when bacteria or other germs spread through the blood from infections affecting other parts of the body, such as your mouth and attach to already weak or damaged areas of your heart. Endocarditis or heart infections, in general, are therefore less common in those with healthy hearts.
How common is it?
Previously, endocarditis diagnosis was common in people aged before their 30s or 40s. However, with more patients having pacemakers and artificial heart valves in their bodies, the average age at onset has climbed to 50 years. With that being said, signs of endocarditis or infective endocarditis symptoms are experienced by 3 – 10 out of 1 Lakh people every year.
Infective endocarditis affects 14.5 cases per 100000 patient-years in India, which is very high compared to the Western incidence, which is around 1.7 – 6.2 cases per 100000 patient-years2.
Types of Endocarditis
There are two main types of endocarditis: acute bacterial endocarditis and subacute bacterial
endocarditis.
Acute Bacterial Endocarditis is when the endocarditis symptoms develop suddenly and become life-threatening within a few weeks.
Subacute Bacterial Endocarditis attacks the system subtly and gradually over a period of several months or even years, if not diagnosed early. This stage can also be life-threatening if left untreated. However, since the growth of infection is at a lower rate, doctors can easily detect and treat it with antibiotics.
Quick Summary
Endocarditis is an inflammation that affects the inner surface of your heart’s chambers and valves, known as the endocardium.
Infective endocarditis symptoms are caused by bacterial or viral infections entering through other parts of the body, which travel to the heart via the bloodstream.
If the symptoms are not recognised and treated promptly, bacteria can grow at a faster rate.
Causes and Risk Factors of Infective Endocarditis
Infective endocarditis is caused by bacteria that get into the bloodstream and travel to your heart. They lock onto damaged parts of your heart and cause inflammation. Some ways that bacteria and germs can enter the bloodstream and affect the heart include:
During dental surgery procedures (if carried out inappropriately)
Oral/gum infections
Unsterilised surgical equipment or needles
Cuts and wounds
Infections that form due to IV procedures or catheters
Infections from a surgical wound
Sexually transmitted diseases
Infective endocarditis may also occur as a result of existing underlying conditions such as:
Sinuses or throat infections
Lung infection, like pneumonia
Heart valve problems
Diabetes
Who is at risk of developing infective endocarditis?
In some cases, endocarditis symptoms may not be diagnosed promptly because the person does not have any symptoms. In others, people with an existing heart condition are at a higher risk of developing infective endocarditis as compared to those without one. Some common conditions that increase your risk of Infective Endocarditis include:
Infections on artificial heart valves: Bacteria can attach to the prosthetic valves at the time of surgery or later on, causing Infective Endocarditis.
Damaged heart valves: A patient with weakened, damaged or older heart valves due to an underlying condition is more likely to get infective endocarditis than one with a young, healthy valve.
Infections from heart transplants: If you have had a transplant, Infective Endocarditis is common because the IV lines used to administer immunosuppressant drugs can let bacteria into your blood.
Implanted heart device: Infections around the device, such as a pacemaker used to treat heart failure or irregular heartbeat, can increase your chance of getting Endocarditis.
Congenital heart defects: CHDs like a heart murmur, aortic stenosis and abnormal heart valves, can increase your risk of Infective Endocarditis. Aortic stenosis treatment involves taking medications, adopting lifestyle changes and undergoing surgical procedures like aortic valve repair or aortic valve replacement.
Poor dental health: Infections of the gums and teeth can lead to Infective Endocarditis.
Previous endocarditis: Having had one episode of Infective Endocarditis increases your risk for this condition, especially if you acquired the infection in your heart valves or a prosthetic valve.
Illegal drug use (IV drugs): Bacteria can enter your bloodstream directly through needle punctures used to inject drugs into the veins, and increase the risk of heart infections.
Infections from catheters: A long-term central venous line or other intravenous catheters that remain in place for more than two weeks increase the risk of Infective Endocarditis.
Older age: Infective Endocarditis is more likely to occur in people over the age of 50. Infection-causing bacteria can be eliminated from your body by healthy white blood cells, but this process slows down as you get older.
Speak to your doctor if you feel you might be at risk of developing a heart infection. The earlier the risk is identified and lowered, the better for your heart health in the long run.
How can infective endocarditis be prevented?
The following measures can help in reducing the risk of infective endocarditis to a significant extent:
Maintain good oral health: Follow oral health practices such as flossing your teeth regularly, checking if your dentures fit properly and visiting your dentist once every six months. Generally, maintaining good oral hygiene is known to be more effective in helping prevent infective endocarditis than taking preventive medications during certain medical procedures.
Take preventive medications: People who are at a higher risk of developing infective endocarditis can considerably benefit from taking preventive medications before undergoing certain types of medical procedures. It is recommended to consult your doctors to identify the right kind of medications and the correct dosage.
Keep in mind that not all cases ofinfective endocarditis can be prevented with awareness about the risk factors. Get in touch with your doctor if you have symptoms of infective endocarditis (discussed in the next section) without any delay, as early diagnosis can pave the way for easier and effective treatment.
Quick Summary
There are several risk factors that can increase your risk of Infective Endocarditis, such as old age, a history of endocarditis, renal failure and smoking.
Infective Endocarditis can affect people with a wide range of conditions such as rheumatic fever, artificial heart valves and poor dental health.
Infectious endocarditis is more common in people over the age of 50, hence, tracking your health is very important.
Signs and Symptoms of Endocarditis
Endocarditis symptoms can arise gradually or suddenly. This is purely based on:
The type of bacteria or germs that may be causing the heart infection.
The effect of an underlying heart problem.
Endocarditis symptoms may vary from individual to individual.
Fever & Flu-like symptoms: Infective endocarditis is often associated with fever coupled with chills and night sweats. The average temperature in Infective Endocarditis is generally above 38°C (100.58 °F).
Unexplained weight loss: This condition leads to rapid, unintentional weight loss.
Weakness or fatigue: Infective Endocarditis can worsen a pre-existing heart disease, which may make some activities harder for you to do than before your infection developed.
Chest pain (especially while breathing): Chest pain is another common symptom, especially while breathing. It usually occurs only in one location, often over the left side of your chest.
Shortness of breath: Endocarditis patients sometimes experience shortness of breath, heart infections that affect the amount of oxygenated blood circulating through their bodies.
Blood in urine: Some patients may notice blood in their urine, which can be a sign of Infective Endocarditis or another kidney infection.
Red skin rash: Infection-related rashes are a sign of Infective Endocarditis. It may appear as small, flat red spots on the trunk of your body or face and may quickly grow in size before turning purple and then brown.
White spots in the mouth or tongue: Infection in your heart can cause white spots to appear on the inside of your mouth and tongue if it spreads. Infective Endocarditis patients may also notice that they have a metallic taste in their mouths or food that seems less appealing anymore3.
Pain and swelling in joints: Endocarditis may sometimes cause joint pain and swelling called Osler nodes, especially in the fingers and toes.
Heart Murmur: Endocarditis may cause abnormal heart sounds due to damage to heart valves.
Some people with endocarditis don’t realise how sick they are until it’s too late to reverse their condition, leading to heart failure, paralysis, memory loss, numbness in arms or legs if the infection spreads beyond your body’s cardiovascular system into surrounding muscle tissue. These are signs that you may require more aggressive infective endocarditis treatment as quickly as possible. Therefore, speak to your doctor if and when you experience even the earliest of signs to rule out your diagnosis4.
Quick Summary
The primary endocarditis symptoms include pain and swelling of joints, chest pain, fever and fatigue.
Infected Heart Valve Disease also causes other symptoms like shortness of breath or red rash around ankles & feet spreading to other body parts.
The symptoms may show up days or weeks before Infective Endocarditis is diagnosed.
Diagnosing Infective Endocarditis
If your doctor notices you may be showing signs and symptoms of infective endocarditis, especially when you also fall under the risk bracket, he may recommend a few tests to rule out the chances of it being a heart infection.
An endocarditis diagnosis may include one of the following tests:
Physical Exam: An important aspect of diagnosis – your doctor will examine clinically and check your pulse, blood pressure, body weight, heart sounds, breathing and other parameters along with a detailed medical history to understand your condition.
Blood Tests:
A complete blood count (CBC) will show any changes in haemoglobin, RBCs and white blood cell levels due to Endocarditis.
Blood Culture and sensitivity testing – Infections caused by bacteria may be detected through lab tests like cultures, where doctors check for specific germs in samples taken from body tissues or blood. This can help determine which antibiotics work best against the bacteria causing the infection
Some other blood tests as needed.
Echocardiogram: Endocarditis Infection signs can show up on an echocardiogram, giving doctors a clear picture of how serious your condition is and the type of treatment you’ll need. The test uses ultrasound to take pictures inside your heart using sound waves, which can be used to spot blood clots or abnormal valves that may cause bacterial endocarditis.
Electrocardiogram: An endocarditis diagnosis may also include checking for abnormal changes in the electrical activity of your heart, known as arrhythmias. An electrocardiogram (EKG) is used to measure these electrical waves and spot any abnormalities that could indicate bacterial endocarditis.
Chest X-ray: The symptoms can become worse once it spreads outside your heart, causing infections in other organs that can be seen on chest X-rays.
CT and MRI Scans – Infective Endocarditis infection symptoms can lead to abscesses or bone marrow infections that will show up on CT and MRI scans, which use X-rays and magnetic pulses to create detailed images of your body5.
Quick Summary
Doctors may perform a physical examination, X-rays, MRI scans, ECG, etc, to diagnose Infective Endocarditis.
These tests help the doctors to gain a better understanding of the severity of the condition and what kind of treatment to proceed with.
It is also very important to stay mindful and positive during all these treatments for a better recovery.
What are the Treatment Procedures If Diagnosed with Infective Endocarditis?
If your doctor feels that you may be showing early signs of a heart infection like endocarditis, he may advise treatment based on the severity of your condition. The following treatment options can be considered by your doctor:
Antibiotics (IV or oral medications) – Intravenous (IV) antibiotics may be prescribed for a considerable duration (often several weeks or longer). The type of medication and duration are dependent on the type of bacteria causing endocarditis. Oral medications may also be prescribed as part of your initial Infective Endocarditis treatment to ensure any harmful germs have been killed before undergoing more complex procedures like open-heart surgeries to treat the infection further.
Surgical treatments – Your doctor may recommend heart valve surgery as an infective endocarditis treatment option. This is usually done to treat aggressive endocarditis or as a damaged valve replacement measure.
Preparing for the Surgery
Before surgery, you’ll be given some medications depending on your condition. Blood tests may also be done prior to infective endocarditis treatment in India, checking for signs that the preventive antibiotics prior to surgery are working.
How much does an infective endocarditis surgery cost in India?
Cardiovascular surgeries like open-heart surgery, valve replacement surgery, etc, can range from ₹1.5 – 7 lakhs in India. However, these costs are again dependent on the hospital and the city you may be living in.
Recovery and Post-Operation: What to do, and what not to do?
Preventing a relapse requires patients to be more aware of their surroundings and also make a few changes to their lifestyle. Here are a few suggestions that your doctor might recommend in order to protect yourself from another bout of endocarditis:
Do not smoke, drink alcohol or take recreational drugs, as these can cause additional damage.
Avoid heavy lifting for a long time after endocarditis surgery (usually several weeks).
Avoid sharing utensils, towels and dishes with people who could be infected, even family members.
Do’s
Don’ts
Maintain excellent oral and dental hygiene. Schedule regular check-ups at the dentist to keep your teeth and gum health in check.
Smoke or drink
Schedule regular checkups with your cardiologist to keep your heart health in check.
Take recreational/illegal drugs
Wash all your fruits and vegetables thoroughly before consuming them.
Lift heavy weights, especially after surgery
Maintain proper personal hygiene by showering daily, thoroughly washing and disinfecting any clothes, towels, underwear and even utensils that you use.
Miss or skip the doses of antibiotic medications prescribed by your doctor for the treatment of any infection.
Take good care of your skin. Clean any cuts and wounds immediately to avoid the chance of infection.
Share utensils, towels or any personal hygiene products with anyone who you think may be sick.
If preventive measures are not followed properly, some of the complications that might arise include:
Abnormal heart rhythms
Blood clots
Jaundice
Organ injury
Stroke
Heart failure
How to care for someone diagnosed with endocarditis?
People diagnosed with Infective Endocarditis will have to rest a lot during the initial days of treatment, as they can feel fatigued and tired. Here are some more ways you can offer support and help along their journey to recovery:
Help them with physical tasks around the house.
Help them take their medication on time
Accompany them to doctor visits
Share stories, do tasks together that can help lift their spirits and improve their mental health.
Join a support group together
The recovery time after infective endocarditis treatment can vary depending on the patient’s condition and the type of endocarditis treatment done in India. However, showing that you care and they knowing that they have your support and help can go a long way in speeding up their recovery as well6.
Quick Summary
Doctors may prescribe antibiotics during the initial stages of Infective endocarditis treatment.
Surgery may be prescribed if the symptoms worsen over time or if the symptoms are diagnosed late.
Patients must follow a healthy lifestyle, including eating healthy and regular visits to the doctor.
Preventing infective endocarditis starts with your personal hygiene. Make sure you take care of your oral health, as bacteria can build up in your mouth and travel inside your body through the bloodstream, affecting your heart.
Frequently Asked Questions (FAQs)
Is surgery necessary for infective endocarditis?
Infective endocarditis treatment in India usually involves medications for a few months post-diagnosis, depending on how severe your condition is. Surgery is required in severe cases where your valves have been completely damaged. However, it is advised to speak with your doctor about the best treatment plan suited to the severity of your condition.
Can infective endocarditis be cured with antibiotics?
Your doctor may prescribe antibiotics to help manage the condition in its initial stages or as a preventive measure prior to surgery. Medications may also be administered for several months after surgery to ensure complete recovery and prevent damage to your heart valves. It is best to speak with your doctor about the best treatment plan for you.
What type of bacteria causes infective endocarditis?
Infective endocarditis is usually caused by bacteria like Streptococcus and Staphylococcus.
What kind of problems can occur with infective endocarditis?
Infective endocarditis can lead to serious problems like heart damage and dysfunction, stroke, paralysis, aneurysm (a bulge of a blood vessel), heart attack, heart failure or even death in worst cases if left untreated. It is worth noting that the difference between a heart attack and heart failure is heart attack occurs when the blood flow to the heart is suddenly cut off, while heart failure happens when the heart is unable to pump blood as efficiently as it should.
Can infective endocarditis occur from fungi?
Yes, endocarditis can also be caused by fungi. Infections of this type are not as common as those caused by bacteria, but they do require special treatment, which may include antifungal therapy and surgery.
Is infective endocarditis life-threatening?
Yes, Infective Endocarditis can be fatal if untreated. Infections of this type are most common among people with pre-existing health conditions like congenital valve defects, arrhythmias or peripheral vascular disease.
What are the long-term effects of untreated infective endocarditis?
Infective endocarditis Infection can be fatal if it is not treated. It can also cause heart failure (when your heart doesn’t pump enough blood to meet the body’s needs), paralysis, stroke, aneurysm (a bulge of a blood vessel) or death.
Gomes RT, Tiberto LR, Bello VNM, Lima MAJ, Nai GA, De Abreu MAMM. Dermatologic manifestations of infective endocarditis. Anais Brasileiros de Dermatologia. 2016 [cited 2025 Jun 2]. Available from: https://pubmed.ncbi.nlm.nih.gov/28300907/
Bayer AS, Bolger AF, Taubert KA, Wilson W, Steckelberg J, Karchmer AW, et al. Diagnosis and management of infective endocarditis and its complications. Circulation. 1998 [cited 2025 Jun 2]. Available from: https://www.ahajournals.org/doi/10.1161/01.CIR.98.25.2936
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
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