ChatGPT & infective endocarditis: insights into diagnosis, treatment, and patient education
The advent of artificial intelligence (AI) is revolutionizing medicine, offering innovative ways to diagnose and manage medical conditions (1). AI includes technologies that mimic human intelligence, enabling machines to learn, solve problems, and analyze extensive datasets. One notable example is ChatGPT, a generative AI chatbot developed by OpenAI. Designed for conversational dialogue, ChatGPT can respond to follow-up questions, acknowledge errors, correct misunderstandings, and reject inappropriate requests. It is powered by OpenAI’s advanced language model, Generative Pre-trained Transformer (GPT), which has been trained on diverse text data to generate human-like, contextually relevant responses (2).
Infective endocarditis (IE) is an infection of the heart’s inner lining, particularly the valves, caused by bacteria or fungi entering the bloodstream. Individuals with certain risk factors—such as heart valve disease, congenital heart defects, or a history of intravenous drug use—are more susceptible to IE. Common symptoms include persistent fever, fatigue, night sweats, weight loss, and joint or muscle pain. In some cases, a new or worsening heart murmur may develop, along with specific signs such as Osler’s nodes (tender spots on fingers and toes) and Janeway lesions (painless spots on the palms or soles) (3). Diagnosis is based on the modified Duke criteria, with blood cultures identifying the infectious organism and echocardiography visualising vegetation on the valves. Treatment typically involves prolonged intravenous antibiotics, with surgical intervention required in severe cases. Early diagnosis and appropriate management are crucial to preventing serious complications, such as heart failure or systemic embolization (4).
AI is increasingly integral to daily life, particularly in healthcare, enhancing diagnostics, treatment, and disease prediction. In the context of IE, machine learning analyses imaging, lab tests, and clinical records to detect early signs and predict complications, leading to accurate diagnoses and improved outcomes (5).
Table 1 shows a conversation with ChatGPT about IE and its signs and symptoms, diagnosis, risk factors, treatment, and prevention.
Table 1
| Questions | Answer by ChatGPT |
|---|---|
| What is infective endocarditis? | Infective endocarditis is an infection of the inner lining of the heart, known as the endocardium. It typically occurs when bacteria or other pathogens enter the bloodstream and attach to damaged areas of the heart, such as heart valves. This condition can lead to serious complications, including heart failure, stroke, and the spread of infection to other organs |
| Common symptoms include fever, chills, fatigue, shortness of breath, and a heart murmur. Risk factors include pre-existing heart conditions, artificial heart valves, a history of endocarditis, and certain intravenous drug use | |
| Diagnosis usually involves blood tests, echocardiograms, and sometimes other imaging studies. Treatment typically requires a prolonged course of intravenous antibiotics, and in some cases, surgery may be necessary to repair or replace damaged heart valves. Early detection and treatment are crucial for improving outcomes | |
| What are the causes of infective endocarditis? | Infective endocarditis is primarily caused by bacteria, but it can also be caused by fungi or other microorganisms. The main causes include: |
| (I) Bacterial infection: most cases are due to bacteria, particularly: | |
| ○ Staphylococcus aureus: commonly associated with intravenous drug use and skin infections | |
| ○ Streptococcus viridans: often found in the mouth; can enter the bloodstream during dental procedures or poor oral hygiene | |
| ○ Enterococci: typically found in the gastrointestinal tract and urinary tract | |
| (II) Fungal infection: certain fungi, like Candida, can cause endocarditis, especially in immunocompromised individuals | |
| (III) Intravenous drug use: introducing pathogens directly into the bloodstream through non-sterile injection practices | |
| (IV) Existing heart conditions: pre-existing heart conditions, such as congenital heart defects, rheumatic heart disease, or previous heart valve surgery, can predispose individuals to infection | |
| (V) Prosthetic heart valves: the presence of artificial heart valves increases the risk, particularly in the first few months after surgery | |
| (VI) Poor oral hygiene: dental procedures or gum disease can allow bacteria to enter the bloodstream | |
| (VII) Chronic health conditions: conditions like diabetes, HIV, and cancer can increase susceptibility to infections | |
| What are the common symptoms & signs of infective endocarditis? | Common symptoms and signs of infective endocarditis include: |
| Symptoms: | |
| (I) Fever: often persistent and may be accompanied by chills | |
| (II) Fatigue: general feeling of tiredness or weakness | |
| (III) Night sweats: excessive sweating during the night | |
| (IV) Weight loss: unintentional weight loss over time | |
| (V) Shortness of breath: difficulty breathing, especially with exertion | |
| (VI) Muscle and joint pain: general aches or discomfort | |
| Signs: | |
| (I) Heart murmur: abnormal heart sounds detected by a doctor | |
| (II) Petechiae: small, red or purple spots on the skin or mucous membranes | |
| (III) Janeway lesions: painless, flat lesions on the palms or soles | |
| (IV) Osler’s nodes: painful, raised lesions on fingers or toes | |
| (V) Splinter haemorrhages: tiny blood clots that appear as reddish-brown streaks under the nails | |
| (VI) Anaemia: low red blood cell count, which may cause pallor | |
| Complications: signs of complications may also arise, such as signs of stroke (sudden weakness, difficulty speaking) or heart failure (swelling in legs, difficulty breathing) | |
| How can infective endocarditis be diagnosed? | Diagnosing infective endocarditis involves a combination of clinical evaluation, laboratory tests, and imaging studies. Here are the key steps in the diagnostic process: |
| (I) Medical history and physical examination: | |
| • History: a detailed history to identify risk factors, symptoms, and any recent dental or medical procedures | |
| • Physical exam: a thorough examination to look for signs such as heart murmurs, petechiae, or Osler’s nodes | |
| (II) Blood cultures: | |
| • Blood samples are taken to identify the presence of bacteria or fungi in the bloodstream. Typically, multiple cultures are drawn over several hours to increase the chances of detection | |
| (III) Echocardiogram: | |
| • TTE: a non-invasive ultrasound of the heart to visualise heart valves and assess for vegetations (masses of bacteria and tissue) | |
| • TEE: a more sensitive test that involves inserting a probe down the oesophagus to get a clearer image of the heart’s structures, especially useful for detecting issues with prosthetic valves | |
| (IV) Blood tests: | |
| • Additional blood tests may be performed to check for signs of inflammation, such as elevated white blood cell count and CRP | |
| (V) Imaging studies: | |
| • In some cases, imaging studies like CT scans or MRI may be used to evaluate complications, such as embolic events in other organs | |
| (VI) Modified Duke criteria: | |
| • Diagnosis often follows the modified Duke criteria, which considers clinical, microbiological, and echocardiographic findings. It includes major and minor criteria to establish a diagnosis based on the combination of evidence | |
| What is the medical management of infective endocarditis? | The medical management of infective endocarditis primarily involves antibiotic therapy, with additional supportive measures as needed. Here’s a breakdown of the key components: |
| (I) Antibiotic therapy: | |
| • Empirical treatment: broad-spectrum intravenous antibiotics are started immediately after blood cultures are taken. Common regimens may include: | |
| ○ Vancomycin: for MRSA coverage | |
| ○ Ceftriaxone: often added for broader coverage | |
| • Targeted therapy: once the specific pathogen is identified from blood cultures, antibiotic therapy is adjusted based on sensitivity results. Treatment usually lasts 4 to 6 weeks, depending on the organism and patient factors | |
| (II) Supportive care: | |
| • Monitoring: regular monitoring of vital signs, laboratory tests (like kidney function), and clinical status | |
| • Hydration and nutritional support: ensuring the patient remains well-hydrated and receives adequate nutrition | |
| • Management of complications: addressing any complications such as heart failure, embolic events, or abscess formation | |
| (III) Surgical intervention: | |
| • Surgery may be necessary in certain cases, particularly if: | |
| ○ There is significant valve damage or dysfunction | |
| ○ Persistent infection despite appropriate antibiotic therapy | |
| ○ Development of abscesses or other complications that cannot be managed medically | |
| (IV) Follow-up care: | |
| • Regular follow-up appointments to monitor recovery and manage any long-term effects, such as potential valve replacement needs or ongoing heart issues | |
| (V) Preventive measures: | |
| • For high-risk patients, prophylactic antibiotics may be recommended before certain procedures, such as dental work or surgery, to prevent recurrence | |
| What are the complications of infective endocarditis? | Infective endocarditis can lead to several serious complications, which may affect the heart and other parts of the body. Here are some of the most common complications: |
| (I) Heart valve damage: | |
| • The infection can cause severe damage to heart valves, leading to valve dysfunction or failure. This may necessitate surgical repair or replacement | |
| (II) Heart failure: | |
| • Damage to heart valves can impair the heart’s ability to pump blood effectively, potentially leading to heart failure | |
| (III) Embolic events: | |
| • Fragments of infected tissue (vegetations) can break off and travel through the bloodstream, causing emboli. These can lead to: | |
| ○ Stroke: if an embolus blocks a blood vessel in the brain | |
| ○ Pulmonary embolism: if an embolus travels to the lungs | |
| ○ Organ damage: emboli can obstruct blood flow to organs like the kidneys, spleen, or liver, causing damage | |
| (IV) Abscess formation: | |
| • Infected areas in the heart or nearby tissues can develop abscesses, which may require surgical intervention | |
| (V) Sepsis: | |
| • The infection can lead to sepsis, a life-threatening systemic response to infection characterised by widespread inflammation and organ dysfunction | |
| (VI) Conduction abnormalities: | |
| • Infection or abscesses can interfere with the heart’s electrical conduction system, leading to arrhythmias or heart block | |
| (VII) Metastatic infections: | |
| • The bacteria can spread to other areas of the body, potentially causing infections in the lungs, joints, or bones | |
| (VIII) Kidney damage: | |
| • Complications related to emboli can lead to renal failure or damage due to reduced blood flow | |
| (IX) Skin lesions: | |
| • Although not life-threatening, patients may develop lesions such as petechiae, Janeway lesions, or Osler’s nodes |
CRP, C-reactive protein; CT, computed tomography; HIV, human immunodeficiency virus; IE, infective endocarditis; MRI, magnetic resonance imaging; MRSA, methicillin-resistant Staphylococcus aureus; TEE, transesophageal echocardiogram; TTE, transthoracic echocardiogram.
ChatGPT’s responses regarding IE were generally accurate and well-structured, demonstrating a solid understanding of the condition’s pathophysiology, diagnostic criteria, and treatment approaches. It effectively explained key aspects such as the modified Duke criteria. The information provided was clear and comprehensible, making it suitable for educating patients about IE.
However, there were some notable limitations. While the responses highlighted common symptoms and complications, there was limited emphasis on atypical presentations, which can be critical in avoiding delayed diagnoses. Additionally, ChatGPT did not consistently account for individual patient variations in management, which is essential for tailoring treatment plans, particularly in severe or complex cases.
Preliminary user feedback on ChatGPT’s educational utility
To evaluate how effective ChatGPT could be as a learning resource for IE, we carried out a small pilot study with 12 medical trainees, including six final-year medical students and six junior doctors. They were asked to review the conversation presented in Table 1 and provide feedback across three areas using a 5-point Liker scale:
- Clarity of responses:
- Medical accuracy.
- Educational usefulness.
- Results:
- Clarity: 4.5/5.
- Accuracy: 4.3/5.
- Educational usefulness: 4.4/5.
In open-ended comments, participants appreciated the logical flow and straightforward language of the explanations. However, several cautioned that such tools should not be used in isolation and emphasized the importance of clinical oversight. Overall, the feedback suggests that ChatGPT could be a helpful supplement for learners in the early stages of their medical training.
Conclusions
In the context of patient education and preliminary consultations, ChatGPT has significant potential. It can provide foundational knowledge, clarify doubts, and guide patients toward seeking appropriate care. It could serve as a helpful support tool in medical education supported by preliminary feedback. That said, it should always complement, not replace, input from qualified medical professionals. Future advancements should prioritize enhancing ChatGPT’s contextual understanding by integrating comprehensive clinical datasets, particularly for cardiovascular conditions. This integration would ensure the tool delivers accurate, evidence-based information, improving its reliability and utility for both healthcare providers and patients.
Acknowledgments
None.
Footnote
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Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://jmai.amegroups.com/article/view/10.21037/jmai-2025-90/coif). The authors have no conflicts of interest to declare.
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Cite this article as: Pansuria MC, Kanani KR. ChatGPT & infective endocarditis: insights into diagnosis, treatment, and patient education. J Med Artif Intell 2026;9:30.
