Symptoms of Endocarditis
The symptoms of endocarditis can vary widely and often resemble other illnesses, making the condition difficult to diagnose in its early stages. Because endocarditis affects the heart’s inner lining and valves, symptoms arise from infection, inflammation, and impaired blood flow. Prompt recognition is essential to avoid serious complications.
General Symptoms
These are often the first signs:
Fever and chills, especially recurring or persistent
Fatigue and weakness
Muscle and joint pain
Night sweats
Loss of appetite and weight loss
These non-specific symptoms may develop slowly in subacute endocarditis or rapidly in acute cases. Patients may dismiss them as flu or a common infection.
Heart-Related Symptoms
As the infection progresses, patients may notice:
Shortness of breath
Swelling in the legs, feet, or abdomen (due to heart failure)
Chest pain, particularly if the infection affects blood flow
Heart murmurs, which may be new or changing
Doctors often detect a murmur using a stethoscope, especially in people with valve infections.
Specific Signs of Endocarditis
More advanced or classic signs include:
Petechiae – small red or purple spots on the skin or inside the mouth
Osler’s nodes – painful red bumps on fingers or toes
Janeway lesions – painless spots on palms or soles
Roth spots – small retinal haemorrhages seen in eye exams
Splinter haemorrhages – thin, red lines under the nails
These signs appear due to small clots or pieces of infected material travelling from the heart to other parts of the body.
Symptoms of Endocarditis
Complications and Red Flags
In advanced cases, symptoms may include:
Stroke symptoms (sudden weakness, confusion, speech difficulty)
Kidney pain or blood in the urine
Persistent coughing or fluid in the lungs
In South Africa, people living with HIV or in rural areas may present later in the disease course, increasing the risk of complications.
Recognising the symptoms of endocarditis early can be life-saving. Anyone with heart problems, a history of valve disease, or unexplained fever and fatigue should see a doctor without delay.
[Next: Diagnosis of Endocarditis→]
