title: Native valve infective endocarditis in the general population: a 10-year survey of the clinical picture during the 1980s.
abstract: In a population of 930,000 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.
authors.affiliation: Cardiology Department, Odense University Hospital, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Nissen
authors.forename: P F
authors.initials: PF
authors.lastname: Nielsen
authors.forename: M
authors.initials: M
authors.lastname: Frederiksen
authors.forename: C
authors.initials: C
authors.lastname: Helleberg
authors.forename: J S
authors.initials: JS
authors.lastname: Nielsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003430:Cross-Sectional Studies; D003718:Denmark; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D013290:Streptococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery