Outcome of infective endocarditis complicating rheumatic heart disease: the Philippine Heart Center Experience

Abstract:

Rheumatic heart disease has been a common clinical entity we frequently encounter in the Philippines. The disease in itself causes several hemodynamic changes on its victim, what more if this is complicated with infective endocarditis, a rapid deterioration is usually an expected outcome. With the advent of antimicrobial therapy and progress of surgical intervention, a better prognosis has highlighted each patient’s future. A retrospective, cross-sectional review of the outcome of infective endocarditis complicating rheumatic heart disease has been evaluated among pediatric and adult patients admitted at Philippine Heart Center from 1991 to 1998. The outcome of management was based on in-hospital mortality or clinical improvement. The data of 84 patients were collected and 70 per cent of them were managed medically while 30% underwent valve replacement. There was a F: M ratio of 1: 2 with aortic regurgitation as the most common underlying rheumatic valve lesion. The most frequent signs and symptoms were fever and dyspnea. Aortic valve was the most common site of infection; and the most frequent laboratory abnormalities were anemia, leukocytosis and elevated erythrocyte sedimentation rate. Mortality rate was reported at 35% among medically treated individuals with only 6.8% of deaths due to uncontrolled infection. Mortality rate was 16% among those who underwent surgery. Univariate analysis showed that male sex, leukocytosis, elevated erythrocyte sedimentation rate and poor functional capacity were the significant factors related to mortality among medically treated individuals while younger age, underweight and presence of …

Año de publicación:

1999

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