Outcome of Native Valve Endocarditis

OBJECTIVE: To determine the in-hospital outcome of Native Valve Endocarditis patients and associated complications. STUDY DESIGN, PLACE AND DURATION: Hospital based prospective study, Department of Cardiology, Liaquat University Hospital Hyderabad from July 2005 to December 2007. PATIENTS AND METHODS: 56 consecutive patients, who presented with fever, joint pain, dyspnoea, history of Rheumatic fever, previous history of IE, history of I/V drug abusiveness were studied by history, physical examination, 3 blood samples were taken and sent to the laboratory for culture and sensitivity. All patients were evaluated by Doppler echocardiography on day 1, at 14 day, at one month and on 6th week of treatment. Empiric treatment was started on admission and later adjusted according to culture and sensitivity. Descriptive and inferential statistical analysis was performed using SPSS version 16.0. RESULTS: Males out numbered females with ratio 37(66.1%) / 19(33.9%). Definite vegetation was found in 40/56 (71.4%); but definite culture positive cases were 30/56 (53.6%). Complete improvement was seen in 32(57.1%), 08(14.3%) patients died during the course of treatment in hospital, 10(17.9%) were referred for surgery and 06(10.7%) patients developed recurrent episode of infective endocarditis. 13/56(23.2%) patients developed congestive heart failure, recurrent episodes of fever in 8(14.3%) and valvular regurgitation 6(10.7%) cases. CONCLUSION: Our study showed that native valve infective endocarditis is not un common. Early diagnosis and treatment can help in improving morbidity and mortality, overall outcome and can reduce devastating complications associated with infective endocarditis. Patients who require surgical intervention like large vegetations or abscess should be referred for surgery as early as possible to avoid further complications.