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Emergency department management of infective endocarditis-associated stroke

Lauren Gillespie1, Natalie Kreitzer2

  • 1Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH.

Emergency Medicine Practice
|February 15, 2023
PubMed

Insights

Stroke in patients with infective endocarditis is a serious condition. Early diagnosis and treatment, including antibiotics and possibly mechanical thrombectomy, are crucial for better outcomes.

Area of Science:

  • Cardiology
  • Neurology
  • Infectious Diseases

Background:

  • Stroke is a severe complication of infective endocarditis.
  • Diagnosis requires a high index of suspicion due to the condition's unique nature.

Purpose of the Study:

  • To review diagnostic clues from patient history and physical examination.
  • To discuss the workup, treatment, and management strategies for stroke in endocarditis patients.

Main Methods:

  • Review of historical and physical examination findings.
  • Discussion of infection-focused and stroke-focused laboratory testing and neuroimaging.
  • Analysis of current treatment evidence, including antibiotics, mechanical thrombectomy, and surgical options.

Main Results:

  • Empiric antibiotics are the primary treatment; thrombolytics are contraindicated.
  • Mechanical thrombectomy is a viable option for large-vessel occlusion strokes.
  • Multidisciplinary team consultation is essential for optimal management.

Conclusions:

  • Prompt diagnosis and management are vital for improving outcomes in patients with endocarditis-related stroke.
  • A comprehensive approach involving infectious disease and neurological specialists is recommended.

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