Dr Carl Shakespeare consultant cardiologist  
       
 
   
consultant cardiologist
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Conducting System

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Murmurs of the Heart

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arrowEndocarditis
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Endocarditis / Antibiotic Prophylaxis:

This is an inflammatory process that usually results from a blood borne infection that targets heart structures. Areas of increased turbulence make the heart more susceptible to infection. Particular structures include narrow or leaky valves, artificial valves, and repaired or unrepaired septal defects.

Although spontaneous infection can occur, traditionally we think of dental procedures as the most common source. This is because the mouth is the dirtiest part of the body (e.g. nothing more likely to get infected than a human bite!). Endocarditis is often a very slow creeping condition that can take months to diagnose. It usually presents with vague unexplained fevers, night sweats and sometimes skin and nail blemishes. These symptoms would warrant close investigation in anyone with the above heart conditions.

Thus, prevention with antibiotic prophylaxis is still recommended. This applies mostly to when visiting the dentist or major surgical procedures, and does not apply to having blood tests. More recently there has been national guidance recommending less need to use antibiotic prophylaxis. However, most cardiologists would still recommend antibiotic prophylaxis for the above conditions.