Endocarditis strikes approximately 19,000 people in the United States each year, with 2,000 deaths. Men develop endocarditis more often than women, and the illness is more common among people who have one or more of the following risk factors:

• A congenital (present at birth) malformation of the heart or a heart valve, or mitral valve prolapse with mitral valve regurgitation

• A heart valve damaged by rheumatic fever or by age-related valve thickening with calcium deposits

• An implanted device in the heart ( pacemaker wire, artificial heart valve )

• A history of IV drug use

• A chronic (long-term) medical condition that weakens the immune system (alcoholism, diabetes, cancer with chemotherapy)

In about 20 percent to 40 percent of patients who do not have artificial heart valves and who do not use intravenous drugs, no heart problem can be identified that would increase their risk of endocarditis. In the 10 percent to 20 percent of endocarditis patients who have artificial heart valves, infections that follow within 60 days of valve surgery often are caused by a staphylococcus, while endocarditis that occurs later most frequently is caused by a streptococcus.

Symptoms

Symptoms of acute endocarditis include:

• High fever

• Chest pain

• Shortness of breath

• Cough

• Small broken blood vessels (hemorrhages) on the palms and soles of the feet

If severe heart damage causes shock, the patient may collapse suddenly, have a rapid pulse and have pale, cool skin.

Symptoms of subacute endocarditis include:

• Low-grade fever (less than 102.9 degrees Fahrenheit)

• Chills

• Night sweats

• Pain in muscles and joints

• A persistent tired feeling

• Headache

• Shortness of breath

• Poor appetite

• Weight loss

• Small, tender nodules on the fingers or toes

• Tiny broken blood vessels on the whites of the eyes, the palate, inside the cheeks, on the chest or on the fingers and toes