Endocarditis is caused by a bacterial infection in the heart's lining. The main symptoms of endocarditis are chest pain, shortness of breath, fever, and skin changes. Some endocarditis symptoms are similar to those of other conditions, making it important to be seen by a healthcare provider for a proper diagnosis. 

In this article, you will learn about the symptoms of endocarditis, associated risk factors and complications, and signs that indicate it's time to see a healthcare provider.

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Acute vs. Subacute Infective Endocarditis

Endocarditis is also called infective endocarditis. "Infective" means there is an infection present. There are two types: acute and subacute. Acute develops suddenly and can become life-threatening in a matter of days. Subacute develops slowly over weeks or even months. Both conditions are caused by bacteria entering the bloodstream. 

Frequent Symptoms

Endocarditis symptoms can develop differently from person to person. They can be severe, mild, come on suddenly, or happen slowly. Acute endocarditis comes on quickly and requires immediate medical attention. Subacute cases develop slowly, and you may not suspect you have a problem with your heart.

Pay attention to symptoms and contact your healthcare provider if you experience any new or sudden health changes.

The most common symptoms of endocarditis are:

  • Chest pains: When your heart needs to work harder, it can cause pain in your chest.
  • Shortness of breath: Fluid builds up in your lungs, making breathing difficult. If parts of your heart are inflamed, it will be unable to pump enough oxygen-rich blood from your lungs to your heart.
  • Heart murmur: A heart murmur is a condition in which blood flows backward because a valve to the heart does not shut all the way. Endocarditis can worsen an existing heart murmur or cause a new one to appear.
  • Coughing: When fluid is backed up inside your lungs, it can cause coughing spells.
  • Fever or chills: If a bacterial infection is present, you can develop a fever.
  • Muscle, joint, or back pain: When the heart works harder, it can cause pain in other areas, such as your back or joints.
  • Skin changes: People with endocarditis may experience broken blood vessels, painful red or purple bumps, or painless flat, red bumps on the palms of the hands or soles of the feet.

Risk Factors and Complications

A preexisting medical condition can cause complications for people with endocarditis. Bacteria grow more readily on damaged heart valves, so people with a history of heart surgeries or congenital heart abnormalities are at an increased risk of developing this infection.

Risk factors that can cause complications include the following:

  • Age: Older adults are at higher risk for endocarditis.
  • Weakened heart function: Valve surgeries, heart transplants, calcium deposits on the aortic or mitral valves, or a history of endocarditis can increase your risk.
  • IV (intravenous) drug use: Injection or prolonged use of recreational drugs allows bacteria to enter the bloodstream. 
  • Biological sex: Endocarditis is twice as common in males than in females.
  • Genetics: People with congenital heart abnormalities are more likely to develop endocarditis. 

Your heart valve does not get a direct blood supply, so if bacteria enter the valves, white blood cells can’t reach them to help fight the infection. A Staphylococcus aureus (staph) infection is the most common bacteria that cause endocarditis. It gets into your blood through medical or dental procedures or IV drug use.

Dental Procedures and Endocarditis

It’s rare for a dental procedure to cause endocarditis, but some people are at higher risk of this occurring. People with artificial heart valves or repaired artificial valves, people who have had a previous endocarditis infection, adults or children with congenital heart abnormalities, and those with a heart transplant may be prescribed antibiotics before certain dental procedures to prevent infection.

Other complications of endocarditis include:

  • Sepsis (a potentially life-threatening bodily response to an infection)
  • Heart valve damage
  • Heart failure
  • Arrhythmia (abnormal heartbeat rhythm)

When to See a Healthcare Provider

Because endocarditis involves heart function, a few symptoms require emergency medical treatment. If you are at an increased risk of developing endocarditis, call your healthcare provider if you experience the following:

  • Fever/chills
  • A cough that does not go away
  • Sudden or worsening aching joints and muscles

Some symptoms require emergency treatment. Call 911 if you have:

  • Chest pain
  • Severe shortness of breath
  • Fast heart rate 
  • Any symptom that becomes worse


The most common symptoms of endocarditis include chest pains, shortness of breath, coughing, or fever/chills. Other symptoms include muscle or joint pain, broken blood vessels or flat red bumps on the skin, and a worsening heart murmur (or developing a new murmur). Symptoms can occur suddenly or come on slowly. Some people could experience mild symptoms, while others have severe symptoms that need immediate medical treatment. 

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

By Carisa Brewster

Carisa D. Brewster is a freelance journalist with over 20 years of experience writing for newspapers, magazines, and digital publications. She specializes in science and healthcare content.

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