What you need to know about infective endocarditis | 3 min read

Infective endocarditis (IE), also called bacterial endocarditis, is a serious infection of the heart’s inner lining (endocardium) caused by the accumulation of bacteria in the bloodstream. The condition is rare but potentially life-threatening, as the infection can affect not only the heart’s lining but also the valves and the heart muscles that control blood flow circulation through the heart.

Bacteria can enter the bloodstream (bacteraemia) through the mouth, gut, or skin. They can then replicate and settle on abnormal or damaged heart valves, implanted or prosthetic heart valves, or other damaged heart tissue. If this happens, they can damage or even destroy the heart valves. The heart valves are important in guiding blood flow through the heart. They work like doors to keep the blood flowing in one direction. If they become damaged, the results can be very serious.

Typically, the bacteria that cause endocarditis naturally grow on your skin, mouth, digestive system, or airways. The bacteria can move into your bloodstream when you eat, floss, or brush your teeth, have a bowel movement, or develop a skin condition or burn. Bacteraemia can also result after certain surgical and invasive dental procedures, tattooing or piercing, and regularly using intravenous drugs. However, not all bacteria cause endocarditis.

IE commonly presents as a flu-like illness and is difficult to diagnose because the symptoms are like other conditions.

Treatment usually consists of IV antibiotics. The choice of antibiotic and the length of treatment is based on the type of infection causing the endocarditis.

Who is at risk for infective endocarditis?

It can affect anyone, but people with certain heart conditions are more likely to develop infective endocarditis. You are at increased risk if you have the following:

A prosthetic (replacement) heart valve
Previous infective endocarditis

Or some types of

Congenital heart disease (birth defects).

People with the highest risk for poor outcomes from IE may be prescribed antibiotics before certain dental or surgical procedures to reduce their risk. This is called IE prophylaxis. Preventative measures are encouraged where patients are at moderate risk, such as maintaining good oral hygiene and infection control and discouraging tattooing or piercing.

Poor oral health increases the risk of infective endocarditis.

People with gum disease are almost twice as likely to suffer from coronary artery disease compared to those who don’t have periodontitis. Gum disease can cause heart conditions such as infective endocarditis and functional irregularities.

Individuals with existing cardiovascular issues are at a higher risk of developing IE, especially when the gums are infected or when unhealthy gums are manipulated during a dental procedure. People with these risk factors must practice good oral hygiene, including daily brushing and flossing. This helps reduce the risk of developing endocarditis.

How can infective endocarditis be prevented?

Not all cases can be prevented. That’s because it’s hard to know when an infection will occur. The most important thing you can do to lower your risk of developing infective endocarditis, or any other disease linked to poor oral health, is to take excellent care of your mouth. Some people may need preventative antibiotics before surgical, dental, and medical procedures.

You can reduce the risk of IE by maintaining good oral health through regular professional dental care, cleaning, and using dental products such as manual, powered, and ultrasonic toothbrushes; dental floss; and other plaque-removal devices. If you have gum disease and one heart disease risk factor, have an annual medical screening to check your heart health.

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