[Difficulties in the diagnosis of secondary infectious endocarditis]

The paper is devoted to analysis of the case histories of 84 dead patients hospitalized to the Cardiosurgical Center for rheumatic heart disease in 1976-86. In 21 cases it was secondary infective endocarditis, unrecognized in 12 (57%) patients during life. Secondary infective endocarditis was shown to cause an increase in acute phase indices in 60% of the patients with acquired heart disease. Early diagnosis of disease made difficult the use of prednisolone in patients suffering from heart disease with a vague febrile state. Secondary infective endocarditis caused no specific changes of any of the studied indices. Its diagnosis should be based on a combined approach with account of rapid deterioration of a course of rheumatic heart disease and a therapeutic effect.