RT Book, Section
A1 Alpert, Joseph S.
A1 Klotz, Stephen A.
A2 Fuster, Valentin
A2 Harrington, Robert A.
A2 Narula, Jagat
A2 Eapen, Zubin J.
SR Print(0)
ID 1161716152
T1 INFECTIVE ENDOCARDITIS
T2 Hurst's The Heart, 14e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071843249
LK accesscardiology.mhmedical.com/content.aspx?aid=1161716152
RD 2024/04/23
AB Infective  endocarditis  (IE)  is  a  disease  caused  by  a  microbial  infection  involving  the  endothelial  lining  of  intracardiac  structures  such  as  the  heart  valves.  The  infection  is  invariably  fatal  if  untreated.  Infection  commonly  resides  on  one  or  more  of  the  heart  valve  leaflets,  but  may  involve  mural  endocardium,  chordal  structures,  deeper  layers  of  the  myocardium,  and/or  the  pericardium.  The  presence  of  an  intracardiac  or  endovascular  device  provides  a  nidus  for  infection,  as  well  as  a  barrier  to  eradication.  Despite  significant  advances  in  the  diagnosis  and  treatment  of  IE,  6-month  mortality  still  approaches  25%.1,2  Changes  in  both  patient  demographics  and  microbial  biology  involving  an  increased  incidence  of  antibiotic-resistant  organisms  create  challenges  for  contemporary  physicians.  Prompt  recognition  and  diagnosis,  triggered  by  a  high  index  of  clinical  suspicion  in  susceptible  patients,  trigger  aggressive  treatment  and  represent  the  critical  components  of  a  successful  management  strategy.  Combined  medical  and  surgical  intervention  leads  to  improved  outcomes  for  selected  patients.  However,  recent  years  have  not  seen  improved  clinical  outcomes,  despite  medical  and  surgical  advances.3  Patient  education,  attention  to  general  oral-mucosal  hygiene,  and  the  appropriate  limited  use  of  prophylactic  antibiotics  are  the  mainstays  of  a  preventive  strategy.  IE  is  often  a  complex  disease  with  abnormal  function  in  a  number  of  organ  systems.  Management  by  a  team  of  physicians  and  allied  healthcare  providers  is  usually  required.3,4