How Does Endocarditis Affect Your Fingernails? (2024)

Endocarditis is inflammation in the heart’s inner lining. One possible symptom is splinter hemorrhages, thin red or reddish-brown lines under the fingernails. These lines appear when small blood vessels (capillaries) are damaged.

Endocarditis, an infection in the inner lining of the heart, is a rare condition typically caused by a bacterial infection.

Initially, endocarditis may present as flu-like symptoms. But another possible symptom may include a change to your fingertips, known as splinter hemorrhages. These are thin red or reddish-brown lines that appear underneath the fingernails. In this case, you may need to seek medical attention quickly to treat endocarditis and prevent severe complications.

This article explains how a heart infection can affect other parts of your body and why it’s important to seek medical attention promptly.

Early symptoms of endocarditis typically involve flu-like symptoms, including fever, chills, and nausea. As the condition progresses, it has the potential to affect other parts of your body.

For example, you might notice thin, red or reddish-brown vertical lines that appear under your fingertips and run in the direction that the nail grows.

Known as splinter hemorrhages because they can resemble splinters, these marks are a sign that either blood vessels have become swollen and damaged or small clots have injured the capillaries under the nails.

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While splinter hemorrhages can occur because of trauma to the fingertip and other health issues, it’s important to know that one possible reason is endocarditis. Though other symptoms may be more common, these splinter hemorrhages have traditionally been a part of the clinical criteria for diagnosing endocarditis.

Endocarditis is typically the result of a bacterial infection.

The bacteria responsible for this infection can enter the body through a cut in the skin, surgery, or dental work. They can then travel through the bloodstream to the heart where they can attach to the heart valves or get stuck in the lining and begin to grow.

Small clumps of bacteria can also form at the infection site. They can act like blood clots moving through the bloodstream and negatively affect blood flow to the organs.

In rare cases, endocarditis is a result of a fungal infection. These cases are harder to treat and may be fatal.

People are more likely to develop endocarditis if they have a condition that weakens their immune system, heart valve disease, or a long-term central venous line. Having poor dental hygiene habits, a history of IV drug use, and a previous case of endocarditis may also increase your risk.

Read more about the most common causes of endocarditis and other symptoms of the condition.

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It’s important to notify your doctor if you believe you have a splinter hemorrhage, whether it might be caused by endocarditis, any other condition, or possible trauma. Splinter hemorrhages may indicate a serious health concern requiring medical attention.

Research from 2016 notes that as many as a one-third of people with endocarditis develop splinter hemorrhages.

Splinter hemorrhages were traditionally used to diagnose infective endocarditis, or endocarditis caused by an infection. However, they are not the only symptom of endocarditis.

While a splinter hemorrhage itself is not particularly dangerous, endocarditis is a rare, serious condition that can be life threatening. Outlook can vary based on several factors, including the severity of the infection, the type of pathogen, pre-existing health conditions, and complications.

It’s important to seek prompt medical attention if any symptoms of endocarditis — including splinter hemorrhages — appear. Treatment can prevent the condition from causing severe complications.

There is no specific care required for splinter hemorrhages. But it’s important to talk with your doctor about treating endocarditis, if that’s the cause of your fingernail hemorrhages.

Endocarditis is typically treated with IV antibiotics in a hospital setting. In order to determine the antibiotics necessary to effectively treat an infection, doctors may perform blood cultures and consult with infectious disease specialists.

If you receive an endocarditis diagnosis, you can expect to undergo at least 6–8 weeks of antibiotic treatments, though it’s possible that not all of these treatments will be administered in the hospital.

Treatment may also require surgery to replace heart valves and any implanted materials that are affected, such as pacemakers and defibrillators.

Surgery may also be necessary if endocarditis has affected your heart muscle or other parts of the body. For example, surgery may be required for treating fistulas and draining abscesses.

Endocarditis is a rare but potentially fatal condition that can cause small areas of bleeding under the fingernails. Known as splinter hemorrhages, these may indicate blood vessel damage and that endocarditis is in a later stage.

If you are experiencing splinter hemorrhages or have any symptoms of endocarditis, consult your healthcare team immediately to prevent the condition from progressing and causing severe complications.

How Does Endocarditis Affect Your Fingernails? (2024)

FAQs

How Does Endocarditis Affect Your Fingernails? ›

People with bacterial or fungal endocarditis—known collectively as infective endocarditis—typically have flu-like symptoms, including fever, sweats, chills, and fatigue. Other symptoms may also develop, such as tiny red spots on the skin, blood under the fingernails, or blood in the urine.

What are the symptoms of endocarditis in the nails? ›

Other signs can include: Small areas of bleeding under the nails (splinter hemorrhages) Red, painless skin spots on the palms and soles (Janeway lesions) Red, painful nodes in the pads of the fingers and toes (Osler nodes)

What are the nail changes in infective endocarditis? ›

Endocarditis is inflammation in the heart's inner lining. One possible symptom is splinter hemorrhages, thin red or reddish-brown lines under the fingernails. These lines appear when small blood vessels (capillaries) are damaged.

What are the signs of heart disease in fingernails? ›

In the condition called Terry's nails, most of the fingernail looks white except for a narrow red or pink band at the top. Terry's nails sometimes develops because of aging. But in other cases, it may be a symptom of a serious medical condition, such as liver problems, congestive heart failure or diabetes.

What are the skin signs of endocarditis? ›

Painless red, purple or brown flat spots on the soles bottom of the feet or the palms of the hands (Janeway lesions) Painful red or purple bumps or patches of darkened skin (hyperpigmented) on the tips of the fingers or toes (Osler nodes)

What are four signs of infection in nails? ›

Fungal nail infections may cause nails to become discolored, thick, fragile, or cracked. The nail may also become separated from the nail bed.

What are the six signs of infection in nails? ›

What are the symptoms of a nail infection (paronychia)?
  • Pain, swelling and tenderness around the nail.
  • Skin that is red and warm to the touch.
  • Pus that builds up under the skin. A white to yellow, pus-filled abscess may form. If an abscess forms, it may require antibiotics and/or drainage.
Aug 16, 2021

How does heart disease affect your nails? ›

Changes in the finger nails of patients with cardiac disease are caused principally by congestion in the venous system. The bluish discoloration of the nails is a symptom well known to every physician.

How long can you have endocarditis without knowing? ›

The symptoms of acute bacterial endocarditis (ABE) occur within a few weeks of infection. The symptoms of subacute bacterial endocarditis (SBE) may take weeks or months to develop.

What do unhealthy fingernails look like? ›

Abnormalities of the fingernail

See your doctor if you have any of these symptoms: discoloration (dark streaks, white streaks, or changes in nail color) changes in nail shape (curling or clubbing) changes in nail thickness (thickening or thinning)

Why do cardiologists look at your nails? ›

Heart diseases that cause low oxygen levels could be the reason. Onycholysis: This condition occurs when the nail detaches from the nail bed. Usually, this injury results from trauma. If it reoccurs, you may have a heart condition or other systemic associations such as anemia, lung conditions and thyroid disorders.

What are the black lines on my nails with endocarditis? ›

They are named splinter hemorrhages because they look like a splinter under the fingernail. The hemorrhages may be caused by tiny clots that damage the small capillaries under the nails. Splinter hemorrhages can occur with infection of the heart valves (endocarditis).

What fingernails would indicate liver problems? ›

White Nails

If the nails are mostly white with darker rims, this can indicate liver problems, such as hepatitis. In this image, you can see the fingers are also jaundiced, another sign of liver trouble.

How can a doctor tell if you have endocarditis? ›

Tests used to help diagnose endocarditis include:
  1. Blood culture test. This test helps identify germs in the bloodstream. ...
  2. Complete blood count. ...
  3. Echocardiogram. ...
  4. Electrocardiogram (ECG or EKG). ...
  5. Chest X-ray. ...
  6. Computerized tomography (CT) scan or magnetic resonance imaging (MRI).

What are the nodules on the fingers for endocarditis? ›

Osler's nodes are split pea–sized, erythematous, tender nodules located principally on the pads of the fingers and toes. They are few in number at any given time and occur in about 15% of patients with subacute bacterial endocarditis. The lesions are usually transient and clear in 1 to 2 days.

What is the most common physical finding in infective endocarditis? ›

Most patients have detectable heart murmurs. The presence of a murmur is so common (99% of cases) that its absence should cause clinicians to reconsider the diagnosis of IE. The major exception is right-sided IE, in which only one third of patients have a detectable murmur.

Can heart disease cause nail problems? ›

Often, health care professionals link clubbing to conditions associated with the heart and lungs. Because of the clubbing, your fingers will appear swollen, your nails will become more curved and rounded and the skin around them will be unusually shiny. Heart diseases that cause low oxygen levels could be the reason.

What does paronychia look like? ›

If your child has paronychia, it's usually easy to recognize. Look for: an area of red, swollen skin around a nail that's painful, warm, and tender to the touch. a pus-filled blister.

What are Lindsay's nails? ›

Half and half nails or Lindsay's nails is a systemic onychopathy, clinically characterized by a white coloring of the proximal half nail and a red-brown coloration of the distal half of all the nails.

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