Patients with infective endocarditis: Five-year observation from a single reference center

Infective endocarditis (IE) is a serious and, if untreated, usually fatal disease. Diagnosing IE is often considered to be one of the most difficult medical conditions because of the heterogeneous and ambiguous clinical presentation.

The purpose of this study was to investigate diagnostic and therapeutic management in a non-selected group of patients with IE.

A total of 45 patients consecutively admitted to the Department of Cardiology, Medical University of Silesia in Katowice (mean age 53.6 ±18 years; 13 females) with IE between 2009 and 2013 were evaluated. Echocardiography, blood cultures and laboratory tests were performed on every patient upon admission. An analysis of the diagnostic and therapeutic management was performed.

Most frequent predisposing factors were: a history of heart valve replacement and/or repair (40%), dental caries (17.8%) and bicuspid aortic valve (17.8%). The majority of patients were admitted from another hospital (91.1%). Fever (92%) and symptoms of heart failure (80%) were the most common manifestations. Abnormalities in ECG occured in 91.2% of patients. Echocardiography was highly sensitive (>90%) in detecting endocardial changes. Staphylococcal etiology was the most common (33.3%). Surgery procedures were necessary in 62.2% of patients. Arrhythmias (91.1%) and acute heart failure (57.8%) were the most commonly observed complications, although 24.4% of subjects had neurological disorders. The patients studied were burdened with a number of factors predisposing to IE.

The diagnosis of IE can be a difficult challenge. Particular attention should be paid to the care of oral hygiene and treatment of dental diseases in order to reduce the risk of IE developing.