context: Bacteria are all around us, and many live on different parts of our body. But if you have heart problems, bacteria in your bloodstream can attach to damaged tissue and cause an infection called endocarditis. The inner lining of your heart and surface of its valves is called the endocardium. If germs or bacteria from other parts of your body, such as your mouth, spread through your blood and attach to this lining, it causes endocarditis. If the infection isn't treated with antibiotics or surgery, it can do permanent damage and can even be deadly. If you develop endocarditis, you may get sudden symptoms, or you may develop them over time. The way you feel will depend on how healthy your heart is and what caused your infection. The symptoms can also vary from person to person, but you may: Feel like you have the flu. You may develop a fever, chills, and night sweats. You might also feel achiness in your muscles and joints. Have a new heart murmur. Endocarditis can cause a new or additional heart murmur, or unusual sound in your heartbeat, or changes to an existing one. See changes in your skin. Tiny bumps or spots may show up on your hands or feet. You might also see spots on the whites of your eyes or the roof of your mouth because of broken blood vessels. Your skin could be pale. Feel nauseated. You could lose interest in food, feel sick to your stomach, or vomit. Have pain on the left side of your body under your rib cage. This may be a sign your spleen is trying to fight the infection. See blood in your urine. You might be able to see it on your own, or your doctor might see it under a microscope. Have swelling. Your abdomen, legs, or feet could all have swelling. If you have a healthy heart, it's unlikely that you'll develop endocarditis. You're more likely to get it if you have heart problems or artificial heart valves, since this is where infection-causing germs can attach and multiply. Your odds are higher of getting endocarditis if you have damaged or artificial heart valves, or if you were born with a heart defect. You're also at greater odds if you've used intravenous drugs or had endocarditis in the past. If you notice symptoms of endocarditis or your doctor thinks you might have it, he may suggest some tests. He'll also likely listen to your heart with a stethoscope to see if you have a new or changed heart murmur. If he needs more information before making a diagnosis, he may order one or more of the following tests: Blood tests. These will look for bacteria in your bloodstream or show other things related to endocarditis, such as anemia, which means you don't have enough red blood cells. An echocardiogram or an electrocardiogram. These are tests that show how your heart is working. An echocardiogram uses an ultrasound device to produce images of your heart. An electrocardiogram uses sensors to measure the timing and length of your heartbeat. An X-ray. This will show if endocarditis has affected your heart or lungs. A CT scan or MRI. These tests use pictures to show your doctor if the infection has spread to another area of your body like your brain or chest. In most cases, your doctor will prescribe antibiotics. Usually, you will stay in the hospital for about a week to receive them through an IV. You may need IV antibiotics for between 2 and 6 weeks, but some of that might be from home. Your team at the hospital will help you make arrangements to finish the medication and receive follow-up care. In some cases, endocarditis requires surgery to completely clear it, or to replace a damaged heart valve. Whether or not you need surgery will depend on your specific case and the type of infection you have. Understanding how to recognize the signs of endocarditis can help you get quick treatment. If you notice any symptoms, contact your doctor immediately. If you're diagnosed with endocarditis, you may want to get a special card from the American Heart Association to keep in your wallet. Dental hygiene is an important part of endocarditis prevention. Germs from infections in your mouth can travel to your heart through your bloodstream and cause the infection. Always make sure to brush and floss your teeth and gums and go to the dentist regularly. You should also be cautious about getting piercings or tattoos if you're at higher risk for developing endocarditis. These kinds of procedures can make it easier for germs to get into your system. If you get a skin infection or cut that doesn't heal properly, you should contact your doctor. Before getting any kind of medical or dental procedure, be sure to let your doctor or dentist know that you may be at risk for endocarditis. That way, they can decide whether to prescribe antibiotics before your procedure as a precaution to keep you safe from infection.