Infective Endocarditis in Adult Patients With Congenital Heart Disease

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• Advances in paediatric cardiology and cardiac surgery have led to a growing population of adults with congenital heart disease (CHD).
• Survival rates for individuals with CHD into adulthood now exceed 95%.
• Despite improved survival, adults with CHD have a substantially increased incidence of infective endocarditis (IE).

Purpose of the Study:

• To highlight the increased risk and impact of infective endocarditis (IE) in adults with congenital heart disease (CHD).
• To underscore the significance of CHD as a primary risk factor for IE, particularly in pediatric populations in high-income countries.

Main Methods:

• Literature review and synthesis of epidemiological data on IE incidence in CHD populations.
• Comparative analysis of IE prevalence in CHD patients versus the general population.
• Examination of age-related factors and risk stratification for IE in CHD.

Main Results:

• The incidence of IE in adults with CHD is 1-19 cases per 1,000 person-years, a 30-fold increase compared to the general population.
• IE accounts for 6-10% of all IE cases, with a younger median age of presentation (around 30 years).
• Congenital heart disease is the leading risk factor for IE in pediatric populations in high-income countries.

Conclusions:

• Adults with congenital heart disease represent a vulnerable population with a high burden of infective endocarditis.
• Congenital heart disease is a critical risk factor for IE, necessitating targeted prevention and management strategies.
• The rising prevalence of adults with CHD underscores the importance of addressing IE risks in this demographic.