Българска кардиология (Dec 2022)

Infectious endocarditis – current profile

  • B. Dobreva-Yatseva,
  • F. Nikolov,
  • R. Raycheva,
  • M. Tokmakova

DOI
https://doi.org/10.3897/bgcardio.28.e90366
Journal volume & issue
Vol. 28, no. 4
pp. 92 – 111

Abstract

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Infective endocarditis (IE) is a disease of the endocardium of the heart and the endocardium of the great vessels, with infection affecting heart valves (native or prosthetic) and subvalvular structures and, in the last few decades, indwelling intracardiac devices or catheters. It is a life-threatening disease with a wide distribution worldwide. IE was first described 350 years ago, but it continues to be a huge challenge for doctors for several reasons. First – IE is a changing disease. Nowadays, the profile of patients with IE has significantly changed in terms of age, predisposing factors, microbiological causative agent, clinical picture, complications, therapeutic approach. Second, despite modern imaging and microbiological methods, diagnostics often encounter serious difficulties and delays. Third, the improvement in medical and surgical treatment in recent decades has not changed the rates of mortality and severe complications. Knowing the current profile of patients with IE helps in timely and accurate diagnosis, which is key to starting adequate treatment. Early identification of high-risk patients is important for the therapeutic approach, especially when deciding on operative treatment. This is associated with a reduction in in-hospital mortality and an improvement in the long-term prognosis of patients.

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