Infective endocarditis complicating mitral valve prolapse: epidemiologic, clinical, and microbiologic aspects

Area of Science:

• Cardiology
• Infectious Diseases

Background:

• Mitral valve prolapse (MVP) is a common cardiac condition.
• Infective endocarditis (IE) can develop in patients with MVP.
• Previous literature has documented cases of IE superimposed on MVP.

Purpose of the Study:

• To review and synthesize existing literature on infective endocarditis in patients with mitral valve prolapse.
• To analyze demographic, clinical, and microbiological features of these cases.
• To assess outcomes and complications associated with IE in MVP patients.

Main Methods:

• Systematic review of English-language literature.
• Analysis of 267 reported cases from 72 publications.
• Examination of patient demographics, clinical presentation, causative agents, and outcomes.

Main Results:

• 72 reports described 267 cases of IE on MVP over two decades.
• Men predominated in cases over 40 and in surgical/autopsy series.
• Viridans streptococci were most frequent (46%), but other organisms and age >40 were linked to mortality.
• Complications were common, with 42 patients needing valve replacement.
• MVP is increasingly recognized as an IE precursor due to prevalence and echocardiography.

Conclusions:

• Infective endocarditis is a significant complication of mitral valve prolapse.
• Risk factors for mortality include specific pathogens and advanced age.
• The role of endocarditis prophylaxis in MVP patients requires further risk/benefit analysis.