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[Underlying cardiac disease in infective endocarditis]
T Fujiwara1, T Murakami, H Inada
1Kawasaki Medical School, Kurashiki, Japan.
Insights
Infective endocarditis often affects the aortic valve, even without prior heart conditions. Surgery is frequently needed for patients with no preexisting cardiac disease or those with implanted devices during active infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Cardiac Surgery
Context:
- Infective endocarditis (IE) is a serious infection affecting heart valves and inner lining.
- Understanding the role of underlying cardiac lesions is crucial for managing IE.
- This study examines adult cases of IE to identify associated cardiac conditions.
Purpose:
- To investigate the prevalence of underlying cardiac lesions in adult patients diagnosed with infective endocarditis.
- To determine the frequency of IE in patients without pre-existing cardiac disease.
- To analyze the need for surgical intervention in different patient subgroups.
Summary:
- Out of 39 adult cases, 18 (46%) had no evidence of pre-existing cardiac disease.
- The aortic valve was a frequent site of infection.
- Surgery was required for patients without prior cardiac conditions and those with intracardiac devices (pacemaker lead, aortic valve prosthesis) during active IE.
- Patients with rheumatic valvular disease underwent surgery post-medical treatment for inflammation suppression.
Impact:
- Highlights that infective endocarditis can occur in individuals with structurally normal hearts.
- Emphasizes the importance of considering surgical options for IE patients with intracardiac devices.
- Informs clinical decision-making regarding the management of infective endocarditis, particularly concerning surgical intervention.
Abstract:
Underlying cardiac lesions in 39 adult cases with infective endocarditis were studied. 18 cases (46%) of the patients had no evidence of preexisting cardiac disease and infection frequently involved aortic valve. The patients without preexisting cardiac disease and 4 patients with an intracardiac substitute including pacemaker lead and aortic valve prosthesis required a surgery during an active infective endocarditis. All cases of active infective endocarditis accompanied with rheumatic valvular disease underwent surgery after a suppression of active inflammation by medical treatment.