Infektivni endokarditis

Abstract

Infective endocarditis (IE) was first described more than 350 years ago. It is a disease of the endocardial surface of the heart. Infection typically involves the cardiac valves (native or prosthetic) or an indwelling cardiac device. The cardiac manifestations could include valvular vegetation, abscess, periannular extension of infection. The clinical manifestations of IE are protean and can involve all organic system. Early clinical suspicion and rapid diagnosis are crucial for adequate treatment and reduction of complications and mortality. Integrating clinical results, imaging, and biomarkers are traditionally applied in suspected IE modified Duke criteria. New imaging technologies, such as multi-slice computed tomography, photon-emission computed tomography, and magnetic resonance imaging, might add value to conventional echocardiography in diagnosis and management of IE. Complications from IE are common, and include congestive heart failure, embolism, septic shock, invasive infection, prosthetic valve dehiscence, heart block, and mycotic aneurysm. Intravenous antibiotics are first-line therapy with cardiac surgery being reserved for certain complications of IE and/or for clinical situations in which there is a high risk of complications. Longstanding controversies such as the timing of surgery or the role of antibiotic prophylaxis have not been resolved.