Endocarditis

# Endocarditis
- Modified Duke Criteria: ***
	- If possible IE, plan for FGD-PET/CT
- BC x2
- TTE ordered to assess for vegetations, characterize the hemodynamic severity of valvular lesions, assess ventricular function and pulmonary pressures, and detect complications
	- If TTE nondiagnostic, plan to proceed with TEE
- If paravalvular infection suspected, will order CT

• TEE has better sensitivity for detecting bacterial endocarditis compared to TTE
• Native valve vs. Prosthetic valve? - Timing of infection after valve intervention?
• Fatal if untreated
  • in-hospital mortality rate is 15% to 20%, with a 1-year mortality rate approaching 40% ¹

Diagnosis

Modified Duke Criteria

Management

Complications

• Progression to involve the valve annulus → fistula between the LA and LV, which could result in significant regurgitation.

Footnotes

1. Otto, C. M., Nishimura, R. A., Bonow, R. O., Carabello, B. A., Erwin, J. P., Gentile, F., Jneid, H., Krieger, E. V., Mack, M., McLeod, C., O’Gara, P. T., Rigolin, V. H., Sundt, T. M., Thompson, A., & Toly, C. (2021). 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease. Journal of the American College of Cardiology, 77(4), e25–e197. https://doi.org/10.1016/j.jacc.2020.11.018 ↩