Endocarditis - Diagnosing endocarditis

To diagnose endocarditis, your GP will look closely at your medical history, paying particular attention to any problems that you may have had with your heart.

Taking a medical history will also allow your GP to identify whether you have undergone any recent medical procedures that may have put you at risk of developing endocarditis, such as surgery to the heart valves.

Physical examination

Your GP will check for the symptoms of endocarditis, such as fever or nodules (small lumps) on your fingers and toes.

They will also listen to your heart using a stethoscope to see if you have developed a heart murmur. A heart murmur is where your heartbeat has an extra, or unusual, sound caused by a disturbed blood flow through the heart.

The symptoms of endocarditis are very similar to those of other conditions, so it is important that other possible causes are ruled out. You may therefore be referred for further tests.

Blood tests

A blood culture test is usually taken to check for bacteria or fungi. It can be used to isolate the specific organism responsible for the infection. If bacteria or fungi are identified, they can be tested against a variety of antibiotics to find the most effective treatment.

Another type of blood test is known as erythrocyte sedimentation rate (ESR) test. During an ESR test, a sample of your red blood cells is placed into a test tube of liquid. It is then timed to see how fast the cells fall to the bottom of the tube in millimetres per hour.

If they are sinking faster than usual, it could indicate that you have an inflammatory condition, such as endocarditis.

Another way of measuring inflammation is with a C reactive protein (CRP) test. CRP is produced by the liver and if there is more than usual, there is inflammation in your body.

About 90% of endocarditis patients have an elevated ESR or CRP.

Echocardiogram

An echocardiogram uses sound waves to scan your heart. The waves can produce accurate images of the heart muscle, chambers and valves. This allows your doctor to examine the structure and function of your heart more closely.

An echocardiogram is often used to check for any clumps of bacteria that may have formed, and can help detect infected or damaged heart tissue.

These scans can be performed by either:

directly placing a probe on your chest
swallowing a probe to allow your heart to be studied from inside the gullet (transoesophageal echo)

The transoesophageal echo allows much clearer images of your heart as the gullet is just behind the heart.

Computerised tomography (CT) scan

A computerised tomography (CT) scan uses X-rays to take pictures of your body. A computer is then used to piece the images together.

A CT scan can be useful for identifying any abscesses (collections of pus) that may have developed in your body.

Abscesses: An abscess is a lump containing pus, which is made by the body during infection.
Antibiotics: Antibiotics are medicines that can be used to treat infections caused by micro-organisms, usually bacteria or fungi. For example amoxicillin, streptomycin and erythromycin.
Blood test: During a blood test a sample of blood is taken from a vein through a needle, so it can be examined in a laboratory.
Fever: A high temperature, also known as a fever, is when someone's body temperature goes above the normal 37°C (98.6°F).
Haemorrhage: To haemorrhage means to bleed or lose blood.
Heart valves: Heart valves are four sets of flaps that control the direction that blood pumps around the heart.
Nodules: A nodule is a small growth or lump of tissue.