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Infective endocarditis: a prospective study of 60 consecutive cases
Y A Kiwan1, N Hayat, D G Vijayaraghavan
1Department of Cardiology, Chest Diseases Hospital, Kuwait.
Materia Medica Polona. Polish Journal of Medicine and Pharmacy
|July 1, 1990
Summary
This study on infective endocarditis found Streptococcus viridans to be the most common cause. Two-dimensional echocardiography (2D-Echo) effectively detected vegetations and complications, guiding early surgical intervention for better outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Microbiology
Background:
- Infective endocarditis (IE) is a serious infection affecting heart valves.
- Understanding the causative organisms and diagnostic tools is crucial for patient management.
Purpose of the Study:
- To prospectively analyze cases of infective endocarditis.
- To evaluate the role of two-dimensional echocardiography (2D-Echo) in diagnosing IE and its complications.
- To assess outcomes of medical versus surgical management.
Main Methods:
- Prospective study of 60 infective endocarditis cases (May 1985 - Dec 1988).
- Blood, bone marrow, and surgical valve cultures for organism identification.
- Two-dimensional echocardiography (2D-Echo) performed on all patients.
- Analysis of patient demographics, valve involvement, and treatment outcomes.
Main Results:
- Streptococcus viridans was the most frequent pathogen.
- Culture positivity was 73% overall.
- 2D-Echo detected vegetations in 80% of cases and identified complications like abscesses and ruptured chordae.
- Early surgery was performed in 31 patients due to severe heart failure, embolization, persistent fever, or large vegetations.
Conclusions:
- 2D-Echo is invaluable for IE diagnosis and complication detection.
- Early surgical intervention is often necessary, particularly in a referral center setting.
- While medical treatment had a mortality of 6.9%, surgical intervention had a mortality of 16%.