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Understanding endocarditis

Can a visit to the dentist for a routine cleaning put you at risk for heart disease? The answer usually is no—unless you have a preexisting condition that may make you susceptible to endocarditis, an infection of the lining of the heart’s chambers and valves. In that case, dental work could allow bacteria to reach and infect the heart’s valves. Once inflamed, the valves may cling to surrounding tissue and become unable to act as the gatekeepers for normal blood flow through the heart.

Damaged valves also can produce lesions that break off and travel through the bloodstream, where they can turn into potentially deadly embolisms.

Symptoms of endocarditis include fever, chills and weight loss as well as various bumps and discolorations on the hands and feet. The condition is most often diagnosed with an echocardiogram and a blood test for the presence of bacteria.

Who’s at risk?

Endocarditis is a common complication of rheumatic fever, a childhood disease caused by untreated streptococcal (“strep”) infection. For this reason, it’s important to have your doctor test for strep whenever your child has a sore throat, swollen glands or difficulty swallowing. Strep infections can be easily treated to prevent further complications.

Other people at risk for endocarditis include those with abnormal, damaged or artificial heart valves.

Protect yourself

Although most cases of endocarditis are effectively treated with antibiotics, there still is potential for complications. New guidelines from the American Heart Association suggest that only those people at highest risk of complications should take preventive antibiotics before having dental work. They include people with artificial heart valves, certain serious congenital (present from birth) heart conditions, a history of endocarditis or a heart transplant with a problem in a valve. Preventive antibiotics can help kill any bacteria that enter the bloodstream, thus minimizing the risk of developing endocarditis.