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Adding Fuel to the Fire: Infective Endocarditis and the Challenge of Cerebrovascular Complications

Malveeka Sharma1, Arielle P Davis2

  • 1Department of Neurology, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Box 359775, Seattle, WA, 98104-2420, USA.

Current Cardiology Reports
|March 27, 2023
PubMed

Insights

Infective endocarditis (IE) can cause deadly neurologic complications. This review covers cerebrovascular issues in IE, focusing on safe and successful mechanical thrombectomy and the ongoing debate regarding optimal cardiac surgery timing.

Area of Science:

  • Neurology
  • Cardiology
  • Infectious Diseases

Background:

  • Infective endocarditis (IE) is a serious infection of the heart lining.
  • Neurologic complications significantly increase IE mortality.
  • Cerebrovascular events are a major concern in IE patients.

Purpose of the Study:

  • To review cerebrovascular complications associated with infective endocarditis.
  • To discuss current medical and surgical management strategies for these complications.

Main Methods:

  • Literature review of studies on infective endocarditis and cerebrovascular complications.
  • Analysis of management strategies, including medical treatment and surgical interventions.
  • Evaluation of outcomes related to stroke treatment and cardiac surgery timing.

Main Results:

  • Mechanical thrombectomy is a safe and effective treatment for stroke in IE.
  • The optimal timing for cardiac surgery in IE patients with stroke is still debated.
  • Early cardiac surgery may be safe for patients with small ischemic infarcts, but more data is needed.

Conclusions:

  • Cerebrovascular complications in IE present significant clinical challenges.
  • Further research is required to establish definitive guidelines for cardiac surgery timing in IE with cerebrovascular involvement.
Abstract

Keywords:
Cardiac surgeryInfectious intracranial aneurysmInfective endocarditisIntraparenchymal hemorrhageIschemic strokeMycotic aneurysmNeurologic complications of infective endocarditis

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