Overview
Infective endocarditis (IE) is a serious infection of the inner lining of the heart chambers and valves, known as the endocardium. This infection is typically caused by bacteria entering the bloodstream and attaching to damaged areas of the heart. If left untreated, infective endocarditis can lead to severe complications including heart valve destruction, heart failure, and systemic embolism. In Korea, cardiology and infectious disease specialists use advanced diagnostic tools and multidisciplinary treatment approaches to manage IE effectively.
What is Infective Endocarditis?
Infective endocarditis is an infection that affects the endocardium, most commonly involving the heart valves. It occurs when bacteria or fungi enter the bloodstream and colonize abnormal or damaged heart tissue, forming vegetations—clusters of microorganisms, platelets, and fibrin—that impair heart function. IE can affect native or prosthetic heart valves and can also involve implanted cardiac devices.
Symptoms
- Persistent fever and chills
- Fatigue and weakness
- Heart murmur (new or changing)
- Night sweats
- Muscle and joint pain
- Shortness of breath
- Unexplained weight loss
- Petechiae (small red or purple spots on skin)
- Janeway lesions (painless red spots on palms or soles)
- Osler nodes (painful nodules on fingers or toes)
- Splinter hemorrhages under nails
Causes
- Bacterial entry through oral, skin, or other infections
- Intravenous drug use introducing pathogens directly into bloodstream
- Dental procedures or surgeries without adequate prophylaxis
- Presence of prosthetic heart valves or cardiac devices
- Pre-existing heart conditions such as rheumatic heart disease or congenital defects
Risk Factors
- Damaged or artificial heart valves
- History of infective endocarditis
- Congenital heart defects
- Intravenous drug use
- Poor dental hygiene or recent dental procedures
- Immunocompromised states
Complications
- Heart valve destruction leading to heart failure
- Formation of abscesses in heart tissue
- Embolism causing stroke, organ infarction, or limb ischemia
- Septicemia (bloodstream infection)
- Glomerulonephritis (kidney inflammation) due to immune complex deposition
Prevention
- Prophylactic antibiotics before dental or surgical procedures in high-risk patients
- Maintaining good oral hygiene
- Avoiding intravenous drug use
- Prompt treatment of infections
Treatment Options in Korea
Diagnosis
- Blood cultures to identify causative organisms
- Echocardiography (transthoracic or transesophageal) to visualize vegetations
- Laboratory tests including inflammatory markers and complete blood count
- Imaging studies to detect complications such as emboli
Medical Treatments
- Prolonged course (usually 4-6 weeks) of intravenous antibiotics tailored to culture results
- Supportive care for heart failure or other complications
Surgical or Advanced Therapies
- Valve repair or replacement in cases of severe damage or uncontrolled infection
- Removal of infected cardiac devices if necessary
- Management of complications like abscess drainage
Rehabilitation and Support
- Regular cardiac monitoring after treatment
- Lifestyle modifications to reduce recurrence risk
- Psychological support for lifestyle changes and chronic illness management
Top Hospitals or Clinics in Korea
- Seoul National University Hospital – Cardiology and Infectious Diseases Departments
- Samsung Medical Center – Heart Center and Infectious Diseases Clinic
- Asan Medical Center – Cardiovascular Surgery and Infectious Disease Units
- Yonsei Severance Hospital – Cardiovascular Medicine and Infectious Disease Division
