Endocarditis is a serious and potentially life-threatening condition that affects the inner lining of the heart chambers and valves, known as the endocardium. While it is relatively rare, early detection is crucial for effective treatment and recovery. One of the primary steps in diagnosis is recognizing the symptoms of endocarditis, which can often be subtle and vary from person to person.

What is Endocarditis?

Endocarditis is an infection of the heart’s inner lining, typically caused by bacteria entering the bloodstream and attaching to damaged areas of the heart. While bacteria are the most common culprits, fungi or other germs can also be responsible. The condition can develop suddenly (acute endocarditis) or gradually over time (subacute or chronic endocarditis).

It primarily affects individuals with existing heart problems, prosthetic heart valves, or those who have undergone certain medical procedures. People who inject drugs are also at higher risk.

Understanding the symptoms of endocarditis is essential, as delays in treatment can lead to complications such as heart failure, stroke, or even death.

General Symptoms of Endocarditis

The early symptoms of endocarditis can mimic flu or other infections, making it difficult to diagnose initially. These general symptoms are often persistent and progressively worsen over time.

Fever and Chills :- One of the most common symptoms of endocarditis is a persistent fever. Temperatures often fluctuate but can remain elevated for days or weeks. Chills and night sweats frequently accompany the fever.

Fatigue and Weakness :- People with endocarditis often feel extremely tired and lack energy. This fatigue goes beyond normal tiredness and is typically constant, even after rest. Weakness can be profound and may limit everyday activities.

Shortness of Breath :- Shortness of breath, especially during physical activity or while lying down, may occur. This symptom is usually related to damage to the heart valves, which affects blood flow and oxygen supply.

Muscle and Joint Pain :- Muscle aches and joint pain are common but non-specific symptoms. The pain can be widespread and may resemble the soreness experienced during viral infections or autoimmune conditions.

Loss of Appetite and Weight Loss :- Unintentional weight loss and a reduced appetite are often reported. These symptoms are part of the body’s response to a prolonged infection and inflammation.

Specific Symptoms of Endocarditis

In addition to the general symptoms, endocarditis can cause more specific signs that are indicative of how the infection affects the heart and other organs.

Heart Murmurs :- A new or changing heart murmur is a significant clue. Heart murmurs occur due to turbulence in blood flow across damaged valves. If you already have a murmur, any change in its character may be a red flag.
Persistent Cough :- Some patients develop a chronic cough that doesn’t resolve. This may be related to fluid buildup in the lungs due to heart failure caused by the infection.
Swelling in the Legs, Abdomen, or Feet :- Swelling is a symptom of congestive heart failure, which can develop if the infection causes significant damage to the heart valves. This can lead to fluid retention in the body.
Skin and Nail Changes :- Endocarditis can also cause specific physical changes that may be visible on the skin, nails, or eyes. These are more typical of subacute bacterial endocarditis and may not appear in every case.
Petechiae :- Petechiae are tiny, red or purple spots caused by broken capillaries under the skin. They can appear on the chest, abdomen, inside the mouth, or under the eyes.
Janeway Lesions :- These are painless, flat red spots that appear on the palms of the hands or soles of the feet. They are caused by emboli (clumps of bacteria) traveling through the bloodstream and lodging in small blood vessels.
Osler’s Nodes :- Unlike Janeway lesions, Osler’s nodes are painful and usually found on the fingers and toes. These raised lesions are a sign of immune system activity against the infection.
Splinter Hemorrhages :- These appear as small, red or brown lines under the fingernails or toenails. They resemble splinters and are caused by tiny blood clots.

Eye and Vision-Related Symptoms

In some rare cases, the symptoms of endocarditis can include ocular changes:

Roth Spots :- These are retinal hemorrhages (bleeding spots in the retina of the eye) seen during an eye exam. They appear as round or oval spots with a pale center and may cause vision disturbances.
Neurological Symptoms :- Endocarditis can lead to serious neurological complications if clumps of infected tissue (emboli) break off and travel to the brain.
Confusion or Stroke-Like Symptoms :- Sudden confusion, speech difficulties, numbness, or paralysis on one side of the body could indicate a stroke caused by emboli traveling from the heart to the brain. Immediate medical attention is required.

When to See a Doctor

If you experience a combination of the above symptoms especially persistent fever, unexplained fatigue, and new heart murmurs you should seek medical attention without delay. Endocarditis is not a condition that resolves on its own, and early diagnosis can make a significant difference in the outcome.

Individuals with known heart valve issues, congenital heart defects, or those with prosthetic heart valves should be particularly vigilant. Similarly, anyone with a recent history of invasive dental or surgical procedures should report persistent flu-like symptoms to their doctor.

Conclusion

Endocarditis is a complex condition with a wide range of symptoms that often overlap with more common illnesses. However, recognizing the specific symptoms of endocarditis such as prolonged fever, fatigue, skin lesions, heart murmurs, and neurological signs can be life-saving.

Timely diagnosis and treatment, typically involving antibiotics or even surgery, can prevent serious complications such as heart failure or stroke. If you suspect endocarditis or experience persistent symptoms, consult a healthcare provider promptly for further evaluation.