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Multi-valvular endocarditis
1Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501, USA.
Objective:
Seventy-seven cases of native valve infective endocarditis as determined by the Duke criteria, were reviewed to determine the incidence and clinical features of multi-valvular endocarditis.
Methods:
Fourteen of 77 patients (18%) had multi-valvular endocarditis most commonly involving the mitral and aortic valves. Staphylococcus aureus (43%) and viridans streptococci (36%) were the most common organisms causing multi-valvular endocarditis.
Results:
Definite or probable vegetations were found in 50% of the patients by two-dimensional transthoracic echocardiograph and/or transesophageal echocardiograph, and possible vegetations were detected in 21%. The overall mortality in our series was 21%; 29% underwent valve replacement and 50% were treated medically. The major complications of multi-valvular endocarditis were congestive heart failure (64%), acute renal failure (50%), embolic events (21%), and splenic abscess/infarcts (21%).
Conclusions:
Our data suggests complications of multi-valvular endocarditis, compared with uni-valvular endocarditis are similar except for heart failure. Heart failure is statistically more common in multi-valvular endocarditis (P < or = 0.002).
Insights
Multi-valvular infective endocarditis affects 18% of patients, primarily involving the mitral and aortic valves. While complications are similar to uni-valvular cases, heart failure is significantly more common.
Area of Science:
- Cardiology
- Infectious Diseases
- Valvular Heart Disease
Background:
- Native valve infective endocarditis (IE) is a serious condition affecting heart valves.
- Understanding the specific characteristics of multi-valvular IE is crucial for patient management.
Purpose of the Study:
- To determine the incidence of multi-valvular endocarditis.
- To elucidate the clinical features and complications associated with multi-valvular endocarditis.
Main Methods:
- Retrospective review of 77 native valve infective endocarditis cases using Duke criteria.
- Analysis of patient demographics, causative organisms, diagnostic imaging (echocardiography), treatment, and outcomes.
Main Results:
- Multi-valvular endocarditis was identified in 18% of patients, most commonly affecting mitral and aortic valves.
- Staphylococcus aureus and viridans streptococci were the leading pathogens.
- Major complications included congestive heart failure (64%), acute renal failure (50%), and embolic events (21%).
Conclusions:
- Multi-valvular endocarditis shares many complications with uni-valvular IE.
- Congestive heart failure is a statistically significant complication more frequently observed in multi-valvular endocarditis.
- Findings highlight the importance of early recognition and management of heart failure in these patients.