Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • fever/chills
  • night sweats, malaise, fatigue, anorexia, weight loss, myalgias
  • weakness
  • arthralgias
  • headache
  • shortness of breath
  • meningeal signs
  • cardiac murmur
  • Janeway lesions
  • Osler nodes
  • Roth spots

Other diagnostic factors

  • splinter haemorrhages
  • cutaneous infarcts
  • chest pain
  • back pain
  • palatal petechiae

Risk factors

  • prior hx of infectious endocarditis
  • presence of artificial prosthetic heart valves
  • certain types of congenital heart disease
  • post-heart transplant (patients who develop a cardiac valvulopathy)
  • presence of cardiac implanted electronic device or intravascular catheters (e.g., for haemodialysis)
  • acquired degenerative valve disease
  • mitral valve prolapse (MVP) with valvular regurgitation
  • hypertrophic cardiomyopathy
  • intravenous drug use

Diagnostic investigations

1st investigations to order

  • FBC
  • serum chemistry panel with glucose
  • urinalysis
  • blood cultures
  • ECG
  • echocardiogram
Full details

Investigations to consider

  • rheumatoid factor
  • ESR
  • complement levels
  • computed tomography
  • MRI
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Cardiology Specialist Registrar and Clinical Research Fellow

Department of Cardiovascular Sciences

St George's Hospital Medical School

University of London

London

UK

Disclosures

TKA declares that she has no competing interests.

Cardiology Specialist Registrar and Clinical Research Fellow

Department of Cardiovascular Sciences

St George's Hospital Medical School

University of London

London

UK

Disclosures

AM is an author of a number of references cited in this monograph.

Clinical Lecturer in Cardiology

St George's University of London

London

UK

Disclosures

MP declares that he has no competing interests.

Dr Tracey Keteepe-Arachi, Dr Aneil Malhotra, and Dr Michael Papadakis would like to gratefully acknowledge Professor Sanjay Sharma, Dr Jason C. Schultz, Dr Nisha K. Lassi, and Dr Nandan S. Anavekar, previous contributors to this monograph. JCS, NKL, NSA, and SS declare that they have no competing interests.

Peer reviewers VIEW ALL

Professor of Pediatrics

SMIMER Hospital

Gujarat

India

Disclosures

VD declares that she has no competing interests.

Director

Clinical Epidemiology Unit

Marilia Medical School

Sao Paulo

Brazil

Disclosures

LOC declares that she has no competing interests.

Associate Professor of Medicine

Director, Cardiovascular Disease Fellowship Program

Duke University Medical Center

Durham

NC

Disclosures

AW declares that he has no competing interests.

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