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[Changes in infectious endocarditis in 3 decades]

F Schwytzer, H P Wicki, F Nager

    Schweizerische Medizinische Wochenschrift
    |December 26, 1981
    PubMed
    Summary
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    Infective endocarditis shows an aging patient population and more acute presentations. Despite these changes, improved outcomes and decreased mortality are observed, particularly with timely valve replacement.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Clinical Medicine

    Context:

    • Longitudinal study comparing infective endocarditis (IE) over three phases (1947-1979).
    • Analysis of 101 patients in phase III (1975-1979) against earlier cohorts.
    • Focus on changes in disease course, clinical presentation, and patient outcomes.

    Purpose:

    • To evaluate temporal trends and evolving characteristics of infective endocarditis.
    • To assess the impact of modern medical interventions on IE outcomes.
    • To document changes in clinical presentation, etiology, and mortality.

    Summary:

    • Significant increase in average patient age and a rise in acute and postoperative IE cases.
    • Subacute presentations are decreasing; clinical signs like fever and murmurs are often absent or subtle.

    Related Experiment Videos

  • Emergence of right-heart endocarditis, particularly in intravenous drug abusers, presenting with atypical symptoms.
  • Streptococci and staphylococci remain primary pathogens; blood culture negativity remains high (35%).
  • Despite increased acute cases, overall mortality has declined, highlighting the benefit of urgent valve replacement.
  • Impact:

    • Demonstrates a shift towards older patients and more acute IE presentations.
    • Highlights the challenge of diagnosing IE due to oligosymptomatic presentations.
    • Underscores the improved prognosis and reduced mortality associated with timely cardiac valve surgery.
    • Provides insights into the changing epidemiology and management of infective endocarditis over three decades.