How to diagnose infective endocarditis?

• Published in: Nederlands tijdschrift voor geneeskunde Vol. 166
• Main Authors: Hendriks, Marianne M C, van den Heuvel, Madelon C E, van Straten, A H M, Verduin, C M, Ammerlaan, Heidi A, Houthuizen, Patrick
• Format: Journal Article
• Language: Dutch
• Published: Netherlands 02-02-2022
• Subjects: Aged; Anti-Bacterial Agents - therapeutic use; Echocardiography; Endocarditis - diagnosis; Endocarditis - epidemiology; Endocarditis - etiology; Endocarditis, Bacterial - diagnosis; Endocarditis, Bacterial - microbiology; Heart Valve Prosthesis - adverse effects; Humans
• EISSN: 1876-8784
• ISSN: 0028-2162

We report on three patients with infective endocarditis, which differ greatly in clinical manifestations. Infective endocarditis (IE) is defined by, a mostly bacterial, infection of a native or prosthetic heart valve, the endocardial surface or a cardiac device. It is a rare condition, but it's incidence is increasing because of an increased incidence of elderly patients with chronic disease and cardiac devices. IE is heterogeneous in aetiology, clinical manifestations, and course. It can involve almost any organ system. The presentation often remains subtle and varies with nonspecific symptoms ranging from a mild infection to septic shock and multiorgan failure. IE remains a highly mortal disease, since the diagnosis is missed often. A thorough anamnesis and physical examination can be helpful. Blood cultures prior to antibiotics and echocardiography are key diagnostic steps if there's a clinical suspicion of IE.