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Published on: January 7, 2019
Infective Endocarditis: A Contemporary Review
Scott A Hubers1, Daniel C DeSimone2, Bernard J Gersh1
1Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN.
Insights
Infective endocarditis (IE) diagnosis and management are complex, involving multiple organ systems and requiring multidisciplinary care. Advances in imaging are improving IE detection, especially in at-risk populations.
Area of Science:
- Cardiology
- Infectious Diseases
- Radiology
Background:
- Infective endocarditis (IE) is a serious heart infection affecting the endocardial surface.
- Clinical manifestations of IE are diverse, impacting multiple organ systems and the heart itself.
- Traditional diagnosis relies on echocardiography, but other imaging modalities are increasingly important.
Purpose of the Study:
- To review key aspects of infective endocarditis (IE).
- To focus on emerging diagnostic advances for IE.
- To highlight patient populations at increased risk for IE.
Main Methods:
- Literature search of the PubMed database (January 2000 - September 2019).
- Keywords used: infective endocarditis, diagnosis, management.
- Focus on pertinent and high-quality evidence.
Main Results:
- IE diagnosis and management require a multidisciplinary approach involving various medical specialists.
- Evolving imaging techniques supplement echocardiography in IE diagnosis.
- Certain patient groups, including those with intracardiac devices and congenital heart disease, face growing IE risks.
Conclusions:
- Multidisciplinary care is essential for effective IE management.
- Advances in diagnostic imaging are crucial for timely IE detection.
- Increased vigilance is needed for IE in patients with intracardiac devices and congenital heart disease.
Abstract:
Infective endocarditis (IE), initially described more than 350 years ago, involves infection of the endocardial surface of the heart. The clinical manifestations of IE can involve every organ system, and the cardiac manifestations can include valvular vegetation, abscess, periannular extension of infection, and myopericarditis. Echocardiography is crucial in the diagnosis of IE, but alternative imaging modalities are playing an increasing role in the diagnosis and management of IE. Multidisciplinary care is imperative to the management of IE, often requiring the expertise of cardiologists, cardiothoracic surgeons, infectious diseases specialists, radiologists, and neurologists. We performed a literature search of the PubMed database from January 1st, 2000, to September 30th, 2019, using the terms infective endocarditis, diagnosis, and management to find the most pertinent and highest-quality evidence. This review summarizes key aspects of IE, with a focus on emerging advances in diagnosis. We also highlight growing patient populations at risk for IE, including patients with intracardiac devices and congenital heart disease.
Related Concept Videos
Endocarditis I: Introduction
Endocarditis II: Clinical Features of Infective Endocarditis
Endocarditis III: Medical Management
Endocarditis IV: Nursing Management
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
Pericarditis III: Medical Management

