Infective endocarditis

Infective endocarditis is a serious disease that primarily affects individuals with a specific predisposition and can cause congestive heart failure and other consequences of valvular and periannular destruction, uncontrolled sepsis, emboli, or immune complex disease. Increasing numbers of individuals are at specific risk due to human immunodeficiency virus infection, intravenous drug abuse, or both; therapeutic immunosuppression; and intravascular prosthetic devices. New techniques such as transesophageal echocardiography are becoming available for diagnosing the presence of infective endocarditis and for selecting appropriate therapy. With improvement in surgical techniques to eradicate infection and restore function of valves destroyed by active infective endocarditis, early surgery is often warranted. We review the evolving issues in infective endocarditis related to 1) high risk groups; 2) diagnosis, complications, and prognosis; and 3) surgical considerations.