.svg)
A heart infection from IV drug use, also called infective endocarditis, develops when bacteria travel through the bloodstream and attach to a heart valve. It is a serious condition that can damage the heart within days and needs same-day medical evaluation, not a wait-and-see approach at home. If your loved one injects drugs and has a fever that won't go away, chills, or new shortness of breath, this guide will walk you through what to watch for and what to do next.
What is infective endocarditis and why does it happen with IV drug use?
Infective endocarditis is an infection of the heart's inner lining or one of its valves. Bacteria that enter the bloodstream, often through a needle, a skin infection at an injection site, or drug residue, can travel to the heart and settle on a valve, where they multiply and form a small clump of infected tissue called a vegetation.
Any valve can be affected, but people who inject drugs are at particular risk because injecting bypasses the skin's natural barrier against bacteria. Once a vegetation forms, it can damage the valve, interfere with normal blood flow, and shed infected material into the bloodstream. That last part is what makes this condition so dangerous, and we'll get to it below.
What are the early warning signs your loved one might have a heart infection?
The earliest signs are often easy to mistake for the flu or a lingering cold. A fever that lasts more than a couple of days, chills, and drenching night sweats are the most common first clues, especially in someone who injects drugs and has any kind of skin sore or abscess.
Other signs to watch for include:
None of these signs alone confirms endocarditis, but a fever that won't resolve combined with any of the others in someone who injects drugs is a reason to seek medical evaluation, not to wait it out.
What are embolic symptoms and why do they mean it's time for higher-level care?
Embolic symptoms happen when a piece of the infected vegetation breaks off and travels through the bloodstream to another part of the body. This is one of the most serious complications of endocarditis, and it can affect the brain, lungs, kidneys, spleen, or skin.
Depending on where the fragment lodges, your loved one might experience sudden confusion or weakness on one side of the body, a sudden change in vision, sharp chest pain or coughing up blood, sudden severe back or side pain, or small tender red or purple spots on the fingers, toes, or palms. Any of these symptoms, especially alongside fever, is an emergency. This is the point where a phone call to a primary care office or a wait for an outpatient appointment is not appropriate. Your loved one needs to be seen right away.
When does a heart infection need hospital-level care instead of a clinic visit?
A suspected heart infection always needs hospital-level evaluation, meaning a facility with imaging, lab testing, and 24-hour physician and nursing coverage. Endocarditis is typically treated with weeks of intravenous antibiotics, and doctors need to monitor closely for heart failure, spreading infection, or the need for valve surgery.
If your loved one is in the Clark County area and has already been seen in an emergency department for fever, a new murmur, or embolic symptoms, the next step is often ongoing hospital-level stabilization rather than being sent home. This is the gap Las Vegas Recovery Hospital exists to fill. LVRH is a licensed acute inpatient hospital in Henderson, and it is not an emergency room and not a rehab facility. It picks up after the emergency department has diagnosed and stabilized the immediate crisis, providing continued acute inpatient care for the infection itself while also addressing the substance use factors that contributed to it, including medically managed withdrawal support if your loved one needs it during the same stay.
What questions should you ask the care team?
Good questions help you understand both the medical picture and the plan going forward, and they show your loved one's care team that you're an engaged part of the support system. It's fine to ask more than once if something isn't clear.
A social worker or case manager on the team can usually walk you through logistics, including what case management support looks like once your loved one is ready to move toward the next stage of care.
What should you avoid saying to your loved one right now?
Try to avoid blame or ultimatums while your loved one is medically unstable. Comments like "why did you do this to yourself" or threats about what will happen if they don't quit tend to increase shame and can make someone less likely to accept help, even when it's offered with love.
Instead, focus on the medical facts and your genuine concern. You might say something like, "I'm scared about your heart, and I want you to get the care you need," or simply ask, "What do you need from me right now?" A calm, steady presence often does more than any speech. Peer recovery specialists on staff, who have lived experience with substance use themselves, are often better positioned than family to have deeper conversations about next steps, and peer support is built into care here for that reason.
What happens after the heart infection is treated?
Once your loved one is medically stable, the care team will typically talk about stepping down to a lower level of care. This might mean continuing IV antibiotics as an outpatient, moving into medical detox, or transitioning into residential or outpatient addiction treatment, depending on what the physicians and your loved one decide together.
The goal during the hospital stay is to treat the infection and any related medical complications, such as dehydration, organ strain, or wound infections at injection sites, while also giving your loved one a real entry point into ongoing recovery support if they're ready for it. You can review the full range of services, including wound care for injection-related skin infections, on the services overview page.
Frequently asked questions
Can a heart infection from IV drug use be cured?
Yes, in many cases. Treatment usually involves several weeks of intravenous antibiotics, and some people also need surgery to repair or replace a damaged valve. The outcome depends on how early it's caught, which valve is involved, and whether the infection has spread. A cardiologist can give you specifics for your loved one's situation.
How do people get a heart infection from injecting drugs?
Bacteria can enter the bloodstream through a needle, from a skin infection at an injection site, or from residue in drugs or equipment. Once in the blood, bacteria can attach to a heart valve, especially one already scarred from a prior infection, and multiply there, forming an infected mass called a vegetation.
Is a new heart murmur always a sign of infection?
No, murmurs have many causes and some are harmless. But a new murmur that appears along with fever, chills, or fatigue in someone who injects drugs should be evaluated right away, since that combination is a common presentation of infective endocarditis.
Should I take my loved one to the ER or call a facility like LVRH directly?
Go to the nearest emergency department first if you notice fever, a new murmur, or sudden neurological symptoms, since those need immediate diagnostic testing. Las Vegas Recovery Hospital provides the hospital-level stabilization and continuing care that often follows an ER visit, once the acute emergency has been assessed.
What if my loved one refuses to go to the hospital?
You can't force an adult into care, but you can share what you're seeing and why it worries you, calmly and without ultimatums. Let them know hospital-level care exists that treats both the infection and substance use together, without judgment, so the decision feels less like a confrontation and more like an option.
Will a hospital stay address my loved one's substance use as well as the infection?
Yes, that combination is the core of what a facility like Las Vegas Recovery Hospital does. Addiction-certified physicians, nurse practitioners, and peer recovery specialists work alongside the medical team treating the infection, so withdrawal risk and treatment planning are addressed during the same stay rather than after discharge.
This content is for educational purposes only and is not a substitute for professional medical advice. If you or someone you know is in crisis, call 988 or your local emergency number.
To talk with our admissions team, start the admissions process here or call (702) 941-4673. If you or someone you know is in crisis, call or text 988 anytime.
