‘Reddish-brown lines’ underneath the nails could signal endocarditis

Professor Hugh Watkins on genetic medicines for heart disease

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In this case, “reddish-brown lines” underneath the nails could indicate the presence of a type of infection known as endocarditis.

Rare, but potentially fatal, endocarditis is an infection of the heart lining known as the endocardium.

Most often caused by bacteria entering the blood and travelling to the heart, the condition can cause a range of symptoms.

Reddish brown lines under the nails are just one of 15 symptoms.

The most common symptoms of endocarditis include:
• High temperature
• Chills
• Night sweats
• Headaches
• Shortness of breath
• Cough
• Tiredness
• Muscle and joint pain.

That’s only eight…

Less common symptoms (of which reddish-brown lines are one of them) are:
• Small red, brown, or purple spots on the skin
• Painful red lumps in the pads of the fingers and toes
• Painless red spots on the palms and soles
• Confusion
• Loss of appetite
• Unexpected weight loss.

When should I seek help?

On this, the NHS is clear: “Contact your GP as soon as possible if you develop any symptoms of endocarditis, particularly if you’re at a higher risk of developing it, such as if you have a history of heart disease.”

The NHS also has guidance on when you should seek emergency medical help.

Why would I need emergency medical help?

The reason you might need emergency medical help would be if you had a stroke. A stroke is one of the potential complications of endocarditis, and one which occurs when the blood supply to the brain is suddenly cut off.

Is there any way I can avoid it?

Yes, it is possible to reduce your risk of developing endocarditis, and there are a number of ways to do so.

One of these is to have good oral health by keeping your mouth clean through regular brushing, flossing, and occasional use of mouthwash.

The NHS say: “Visit your dentist on a regular basis to ensure you maintain good oral health and minimise the risk of bacteria entering your bloodstream through your mouth.”

Furthermore, looking after your skin can also have a major impact.


Preventing endocarditis is all about preventing bad bacteria from entering the bloodstream and one of the main ways for bacteria to get into the body is through the skin.

The NHS explains further: “Regular handwashing will help to prevent bacteria spreading. It’s also very important to wash any cuts or grazes carefully as soon as you notice them to prevent them becoming infected.

“Contact your GP for advice if you develop the symptoms of a skin infection. Your GP may prescribe antibiotics as a precaution.”
Antibiotics can also help prevent endocarditis, but these should be used with caution.

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