Subacute bacterial endocarditis in the older age group.

Abstract

In a series of 55 patients with subacute bacterial endocarditis there were 18 aged 50 years or older. The diagnosis was based either on autopsy findings or on the presence of typical signs and symptoms and positive blood cultures. In 3 of the 18 no heart murmurs were detected during life, and even in retrospect adequate clinical criteria were lacking, so that the diagnosis became clear only at autopsy. The atypical nature of many cases resulted in confused diagnoses and misdirected treatment. This was the most common reason for mortality. Thirteen (72 % ) of the 18 older patients died. Among the 37 younger patients only 10 (27%) died. Reasons are given for believing that mortality from this disease in older people can be substantially reduced if the disease is watched for and properly treated.