HEART REVIEW

The changing face of infective endocarditis

B D Prendergast

Department of Cardiology, Wythenshawe Hospital, Manchester, UK

Correspondence to:
Dr Bernard D Prendergast
North-West Regional Cardiothoracic Centre, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK; bernard.prendergast{at}smuht.nwest.nhs.uk

Infective endocarditis (IE) is an evolving disease with a persistently high mortality and morbidity, even in the modern era of advanced diagnostic imaging, improved antimicrobial chemotherapy, and potentially curative surgery. Despite these improvements in health care, the incidence of the disease has remained unchanged over the past two decades and may even be increasing. Chronic rheumatic heart disease is now an uncommon antecedent, whereas degenerative valve disease of the elderly, mitral valve prolapse, intravenous drug misuse, preceding valve replacement, and vascular instrumentation have become increasingly common, coinciding with an increase in staphylococcal infections and those caused by fastidious organisms. The current understanding of this difficult condition is reviewed and recent developments in medical and surgical management are updated.

Abbreviations: ELISA, enzyme linked immunosorbent assay; HACEK, Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae; ICE, International Collaboration on Endocarditis; IE, infective endocarditis; PCR, polymerase chain reaction

Keywords: infective endocarditis; valve disease

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