Journal
ARQUIVOS BRASILEIROS DE CARDIOLOGIA
Volume 118, Issue 5, Pages 976-987Publisher
ARQUIVOS BRASILEIROS CARDIOLOGIA
DOI: 10.36660/abc.20200798
Keywords
Infective Endocarditis; Epidemiology; Diagnosis; Prophylaxis
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Infective endocarditis remains a complex disease that challenges physicians in diagnosis and management. Despite progress in diagnosis and treatment, there are still challenges that need to be addressed, and a comprehensive strategy is crucial to improve patient outcomes.
After fourteen decades of medical and technological evolution, infective endocarditis continues to challenge physicians in its daily diagnosis and management. Its increasing incidence, demographic shifts (affecting older patients), microbiology with higher rates of Staphylococcus infection, still frequent serious complications and substantial mortality make endocarditis a very complex disease. Despite this, innovations in the diagnosis, involving microbiology and imaging, and improvements in intensive care and cardiac surgical techniques, materials and timing can impact the prognosis of this disease. Ongoing challenges persist, including rethinking prophylaxis, improving the diagnosis criteria comprising blood culture-negative endocarditis and prosthetic valve endocarditis, timing of surgical intervention, and whether to perform surgery in the presence of ischemic stroke or in intravenous drug users. A combined strategy on infective endocarditis is crucial, involving advanced clinical decisions and protocols, a multidisciplinary approach, national healthcare organization and health policies to achieve better results for our patients.
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