Infective Endocarditis: A Long Term Experience

Abstract

INTRODUCTION:
Infective endocarditic usually occurs on the abnormal cardiac surfaces. The areas in the heart which are specially affected by the infective vegetative processes are the damaged surfaces affected by the trauma of the haemodynamicjets created between chambers ard great vessels as in ventricular septal defect and semilunar valve stenosis. Rheumatic endocarditis aso predisposes to infective endocarditis. We analysed our hospital experience of infective endocarditis during 1980-1988 period with a view to study the incidence, clinical profile, diagnostic capability and infecting organism profile over an extended period of observation.

MATERIAL AND METHODS:
The patients with infective endocarditis included in the study were searched, retrospectively, from amongst all of the patients who visited the NICVD paediatric cardiology department at the National Institute of Cardiovascular Diseases between 1980-1988. This included patients who were seen in the outpatients department as well as those who were admitted in the paediatric ward.

RESULTS:
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The mean age of 63 patients with infective endocarditis was 9.8±3.0 years, range 3-18 years. The incidence of infective endocarditis was 19.7 per 1,000 for adm i ssions to the children’s ward and 5 per 1,000 patients for out—patients in children under 12 years of age. The overall incidence of infective endocarditis was 4 per 1,000 in children under 12-year age Table Ii.

DISCUSSION:

Our data shows that compared to the incidence reported the literature 1,2 a much higher incidence i.e., 20 per I ,000 Hospital admissions of infective endocarditis was noted in the children under 12 years of age at the National Jnstitiite of Cardiovascular Diseases, Karachi. This may be explainable in various ways.This policy was based on our observation of death due to embolization in children in whom infection was being effectively controlled.