Infective endocarditis is still a serious problem in patients with congenital heart disease

Infective endocarditis (IE) is a life-threatening inflammation of the heart, especially the heart valves. Congenital heart disease (CHD) is a well-known risk factor for IE. Thus far no large prospective studies were undertaken to investigate the risks and outcomes of adult patients with CHD. In a study led by UMCG scientist Joost van Melle, all data from a large European registry (EUROENDO) were analysed with the aim to compare patients with and without CHD.

Their study showed that 12% of all IE patients also had CHD. Although these (often young) patients had better survival than IE patients without CHD, mortality was still high. In the CHD group: 9.0% died while in-hospital. The authors also discovered that CHD patients more often had a dental procedure before hospitalization than non-CHD patients. The time to hospitalization was rather long (on average 5 weeks). When CHD patients were hospitalized the endocarditis was often in very advanced state. The bacteria that caused IE in CHD patients were mainly Staphylococcus aureus and Streptococcus viridans.

“To improve outcome for this growing population, it’s important to instruct our patients how infective endocarditis can be prevented and to educate them about the signs and symptoms of infective endocarditis.”

About the author: Joost van Melle is a cardiologist specialised in congenital heart disease and echocardiography. He is the head of the Adult Congenital Heart Disease programme at the University Medical Centre Groningen, The Netherlands. In this project Van Melle collaborated closely with Gilbert Habib (Marseille, FR) and Jolien Roos-Hesselink (Rotterdam, NL)

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