Profile of right-sided endocarditis: an Indian experience.
The clinical profile of right-sided infective endocarditis in India was studied from a review of records of patients with infective endocarditis admitted to this hospital. From November 1982 to November 1989, 109 patients with infective endocarditis showed vegetations on cross-sectional echocardiography confirming the diagnosis of infective endocarditis. In 19 (17.4%) patients, only the right side of the heart was involved: specifically the tricuspid valve alone in 10; tricuspid and pulmonary valves in 4; tricuspid valve and right ventricular outflow tract in 1; tricuspid valve and right ventricular free wall in 1; pulmonary valve alone in 2; and bifurcation of pulmonary trunk in 1. Eleven patients (57.9%) had underlying congenital heart disease whereas the remaining 8 patients (42.1%) did not have any underlying heart disease. The latter group, therefore, had isolated right-sided infective endocarditis. Previous illnesses leading to isolated right-sided infective endocarditis were: puerperal sepsis in 4; septic abortion in 1; staphylococcal pneumonia in 2; and epididymoorchitis in one. Eight out of 11 patients with congenital heart disease did not report any previous illness. In the remaining 3, right-sided endocarditis followed cardiac surgery in one; dental extraction without prophylaxis in one; and pulmonary balloon valvoplasty in one. All patients with isolated right-sided infective endocarditis had features of septicaemia, but a murmur of tricuspid regurgitation was audible in only 4 (50%) of them. We conclude that, unlike western reports, the pattern of right-sided infective endocarditis in India is different. No drug addict with right-sided infective endocarditis was seen; puerperal sepsis and septic abortion were the commonest causes of isolated right-sided infective endocarditis.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Cardiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
A
A
Grover
I S
IS
Anand
J
J
Varma
R
R
Choudhury
H N
HN
Khattri
R P
RP
Sapru
P S
PS
Bidwai
P L
PL
Wahi
D000031:Abortion, Septic / Q000150:complications; D000293:Adolescent; D000328:Adult; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D011247:Pregnancy; D011645:Puerperal Infection / Q000150:complications; D011664:Pulmonary Valve / Q000000981:diagnostic imaging; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D014261:Tricuspid Valve / Q000000981:diagnostic imaging