Copyright © 1992 by the European Society of Cardiology.
© 1992 The European Society of Cardiology
Native valve infective endocarditis in the general population: a 10-year survey of the clinical picture during the 1980s
*Cardiology Department, Odense University Hospital Denmark
Department of Internal Medicine, Haderslev Hospital Denmark
Department of Internal Medicine, Esbjerg Hospital Denmark
Received 23 July 1991; revised 28 November 1991; .
Correspondence. Dr Henrik Nissen, Department of Cardiology, Odense University Hospital, 5000 Odense C, Denmark.
Abstract
In a population of 930000 inhabitants all records of native valve infective endocarditis diagnosed in the decade 1980–89 were reviewed. Using strict case definitions 132 clinically well-defined or post-mortem diagnosed cases were found. Included were cases referred to the local department of cardiology, as well as cases treated in non-specialized departments. Of 132 cases found 23 were only diagnosed post mortem. The male/female ratio was 71/61. The median prehospital duration of symptoms was 20 days (range 0–180 days) and the median in-hospital diagnostic delay was 5 days (range 0–54 days). Known cardiac disease was found in 42% of cases, a possible portal of entry was found in 33%, but in 36% there were no predisposing factors. Remarkably, only two patients had known rheumatic heart disease and none had a known dental focus. During the clinical course 55% experienced cardiac failure and 17% embolic episodes. In 19 patients surgery was required. Of 111 culture-positive cases streptococci were found in 61 and staphylococci in 45 cases. Echocardiography was performed in 95 cases with echocardiographic signs of endocarditis in 65 patients. Overall mortality was 33% with a mortality in clinically diagnosed cases of 18%. Of 14 cases needing immediate surgical intervention, two died.
Key Words: Endocarditis • native valve • microbiology • mortality • echocardiography • autopsy
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