Infective endocarditis

This week we reviewed a case of infective endocarditis. Check out our past blog post that highlight the Modified Duke's Criteria, also found in the American Heart Association guidelines

Guidelines for surgery include:
1) Valvular dysfunction
       -Valvular perforation or rupture
       -Congestive heart failure
2) Perivalvular extension 
       -Valvular dehiscence, rupture or fistula
       -Conduction abnormalities ie. heart block
       -Abscess
3) Vegetation/Bacteremia
       -Invasive infections ie. fungal IE
       -Persistent embolic events or bacteremia despite adequate treatment
       -Size of vegetation and persistent vegetation (controversial) 

Risk factors for endocarditis include an abnormal valve (ie. mechanical or past valvular disease), or an increased risk of bacteremia (immunocompromised states, IV drug use, permanent lines, hemodialysis etc.)


On a related topic here is an interesting NEJM article - a review on the approach and management of bacterial infections in patients who use illicit drugs