title: Early surgery or medical treatment in endocarditis complicated by embolism from a large, mobile vegetation? A case-based discussion.
abstract: Patients with endocarditis who present after embolism from a large, mobile vegetation pose a clinical dilemma: should they be managed with early surgery with the aim of preventing further emboli, or should a medical strategy be employed that avoids the morbidity and mortality associated with surgery but which risks further emboli? The management of such a patient is discussed in the context of the published literature regarding embolic risk in endocarditis.
authors.affiliation: Department of Cardiology, London Chest Hospital, London, UK.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Haines
authors.forename: Zoe
authors.initials: Z
authors.lastname: Astroulakis
authors.forename: Toufan
authors.initials: T
authors.lastname: Bahrami
authors.forename: R Andrew
authors.initials: RA
authors.lastname: Archbold
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism; D002443:Ceftriaxone / Q000627:therapeutic use; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000150:complications*; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013292:Streptococcus agalactiae / Q000187:drug effects; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D002097:C-Reactive Protein