The endocardium is the inner lining of the heart. Endocarditis is an infection of endocardium or the heart valve that can cause severe damage to the heart and valves. In most instances, a bacteria that's normally found on the skin or in the respiratory, urinary or gastrointestinal tract, enters the bloodstream where it can adhere to a defective heart valve or heart tissue. When it's not treated, endocarditis not only damages the heart and valves but also is capable of generating a systemic infection that spreads throughout the body and is potentially fatal.

The good news is that endocarditis is highly preventable. For starters, if you're diagnosed with a condition that puts you at risk, you can take simple preventive steps to avoid endocarditis. If you're diagnosed with one of the following conditions or have one of surgical corrections listed below, you MUST take the necessary endocarditis precautions:

• Previous bacterial endocarditis infection
• Valvular disease (e.g. mitral valve prolapse associated with valve leaflet thickening and significant regurgitation, tricuspid valve regurgitation or aortic stenosis)
• Surgically constructed pulmonary shunts or conduits
• Congenital heart malformations/disease
• Prosthetic heart valve
• Rheumatic heart disease
• Cardiomyopathy

Easy but critical preventive steps
If you're at risk for endocarditis, you should:

• Inform all of your health care providers (including your dentist) of this condition
• Carry a card in your wallet that says you need to be protected from endocarditis and lists the related diagnosis
• Take all preventive antibiotics as prescribed before:
• ALL dental exams, procedures and tests (including routine dental cleanings)
• ALL respiratory tract surgeries and invasive procedures
• ALL gastrointestinal tract surgeries and invasive procedures
• ALL urinary tract surgeries and invasive procedures

Once again, endocarditis is highly preventable for at-risk individuals. However, if you develop this condition, your symptoms may develop slowly or suddenly and they may include:

• Fever
• Chills, muscle and joint aches
• Cough
• Fatigue, weakness
• Loss of appetite
• Weight loss
• Excessive sweating
• Shortness of breath during and/or after physical exertion
• Edema (swelling of hands, feet and abdomen)
• Blood in urine
• Heart murmur

Your physician may suspect endocarditis after conducting a thorough physical exam. To diagnose endocarditis, your physician may order one or more of the following tests:

• Blood tests
• Echocardiogram
• EKG
• Chest X-ray
• Transesophageal echocardiogram (TEE)

If you're diagnosed with endocarditis, your treatment plan may include:

• Hospitalization to receive IV antibiotics
• Long-term antibiotic therapy
• Bed rest and careful monitoring of physical activity
• Treatment for congestive heart failure, arrhythmias, stroke and other complications that may occur with this disease
• Surgical replacement of the valve

When treated early, the prognosis for this condition is positive and a complete recovery is possible. A delayed diagnosis, as well as factors such as other underlying heart conditions, can complicate the recovery. If the infection is severe enough, surgical replacement of the heart valve may be required. Once again, in most instances, endocarditis is highly preventable in high and moderate risk individuals.