TY - CHAP M1 - Book, Section TI - Infective Endocarditis A1 - Bolger, Ann F. A2 - Fuster, Valentin A2 - Narula, Jagat A2 - Vaishnava, Prashant A2 - Leon, Martin B. A2 - Callans, David J. A2 - Rumsfeld, John S. A2 - Poppas, Athena PY - 2022 T2 - Fuster and Hurst's The Heart, 15e AB - Chapter SummaryThis chapter discusses the pathogenesis and epidemiology of infective endocarditis (IE), as well as the diagnosis and management of patients with this condition (see Fuster and Hurst’s Central Illustration). Cardiac endothelium is normally resistant to infection; endothelial damage, via hemodynamic or mechanical stress, is required for establishment of infection in most cases. The surface of an implanted cardiac device can also be a locus of infection. Bacteria circulating in the bloodstream due to remote infection or transient bacteremia interact with platelets, tissue factors, and endothelium to establish an infective site and form a macroscopic infective mass. Continuous high-grade bacteremia, fragmentation, and direct damage to underlying endocardial tissue and/or valves results. Risk for the development of IE is increased in older adults, persons who inject drugs, individuals with HIV, hemodialysis patients, individuals with cardiovascular implantable electronic devices, and people with prior history of endocarditis. In cases of IE, 6-month mortality is ~25%. Echocardiography should be obtained as soon as possible for any patient with suspected IE. Rapid diagnosis, staging, and careful collaboration between infectious disease, cardiology, and surgical teams to determine the best medical and surgical treatment are important to give the patient their best chance of recovery. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesscardiology.mhmedical.com/content.aspx?aid=1202446485 ER -