Infective endocarditis at autopsy in northern India. A study of 120 cases

Pathologic data on 120 autopsied cases of infective endocarditis are presented. They constitute 1.8% of total 6,700 and 6.3% of 1,900 cardiac autopsies over 16 years. Ninety % of patients were below the age of 40 years, 42.5% had no pre-existing heart disease, 33.3% had previous valvular disease, mainly rheumatic, and 24.2% had congenital heart disease. Mitral and aortic valves were each the sites in one third cases, mitral slightly more than aortic, twenty-six point six % of the cases had lesions on the right side of the heart, 16.6% exclusively so. Cardiac complications were infrequent while systemic infarcts were found in over 80% cases. A route of infection was detected only in 24.1% of the cases, puerperal sepsis being the commonest. Staphylococci were the responsible bacteria in 18 out of 28 cases in which microbiologic data were available. There were only 2 cases with infective lesions on prosthetic valves, both fungal. The pattern of infective endocarditis in this and other reports from India and Africa differs from that in the West, in many respects including younger age of our patients, significant rheumatic background disease, absence of narcotic addicts and of "degenerative heart disease" and lower incidence of cardiac complications.