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.

Related Concept Videos

Endocarditis I: Introduction01:25

Endocarditis I: Introduction

Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
310
Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
283
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
159
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
239
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
343
Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
212