Pathophysiology
Infective endocarditis occurs when  turbulence within  the heart allows causative organism to infect previously damaged valves or other endothelial surfaces.
Vegetations consisting of fibrin, leukosytes, platelets and microbes adhere to  the valve surface or endocardium. The loss of portions of the  friable vegetations into the circulation result  in embolization.  Infection spread to heart valves  leads to 
valvular incompetence, CHF, generalized myocardial dysfunction and sepsis.