OUP user menu

Native valve infective endocarditis in the general population: a 10-year survey of the clinical picture during the 1980s

H. NISSEN , P. F. NIELSEN , M. FREDERIKSEN , C. HELLEBERG , J. S. NIELSEN
DOI: http://dx.doi.org/ 872-877 First published online: 1 July 1992

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.

  • Endocarditis
  • native valve
  • microbiology
  • mortality
  • echocardiography
  • autopsy

Footnotes

    • Received July 23, 1991.
    • Revision received November 28, 1991.

Sign In

ESC members Follow the 'ESC Member and Congress Delegate Sign In' link below for free online access if your subscription to this journal is via the European Society of Cardiology, either as a member or an ESC Congress delegate. Discover if you are an ESC member here.

Otherwise, if your subscription is via OUP, enter your OUP username and password, or select an alternative sign in option below.
 

Log in through your institution