Infective endocarditis in a district general hospital

Area of Science:

• Cardiology
• Infectious Diseases
• Internal Medicine

Background:

• Infective endocarditis (IE) is a serious infection affecting heart valves and endocardium.
• Understanding IE incidence, risk factors, and outcomes is crucial for clinical management.
• Pre-existing cardiac conditions are known risk factors for IE development.

Purpose of the Study:

• To retrospectively analyze the incidence, clinical presentation, microbiology, and outcomes of infective endocarditis.
• To identify factors associated with increased mortality in IE patients.

Main Methods:

• Retrospective analysis of 33 infective endocarditis cases over 6.5 years.
• Data collection included patient demographics, cardiac history, clinical signs, microbiology, and treatment outcomes.
• Statistical analysis was performed to identify factors associated with mortality.

Main Results:

• Annual incidence of IE was 22 cases per million population.
• Twenty-two cases (67%) had pre-existing cardiac disease, primarily valvular or prosthetic valves.
• Viridans-type streptococci were the most common pathogens (14 cases); staphylococcal infections occurred in drug abusers and prosthetic valve patients.
• Cardiac failure (20 cases), renal impairment (19 cases), and embolic phenomena (12 cases) were common complications.
• Mortality was 24% (8 cases), with cardiac failure being the leading cause of death.

Conclusions:

• Infective endocarditis presents with non-specific symptoms, often in patients with underlying heart disease.
• Cardiac failure, renal impairment, and embolic events are significant predictors of mortality.
• Prompt diagnosis and management, including consideration for surgical intervention, are vital for improving outcomes in IE.