Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN.
Department of Cardiovascular Disease, Mayo Clinic, Rochester, MN; Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Mayo Clin Proc. 2020 May;95(5):982-997. doi: 10.1016/j.mayocp.2019.12.008. Epub 2020 Apr 13.
Infective endocarditis (IE), initially described more than 350 years ago, involves infection of the endocardial surface of the heart. The clinical manifestations of IE can involve every organ system, and the cardiac manifestations can include valvular vegetation, abscess, periannular extension of infection, and myopericarditis. Echocardiography is crucial in the diagnosis of IE, but alternative imaging modalities are playing an increasing role in the diagnosis and management of IE. Multidisciplinary care is imperative to the management of IE, often requiring the expertise of cardiologists, cardiothoracic surgeons, infectious diseases specialists, radiologists, and neurologists. We performed a literature search of the PubMed database from January 1st, 2000, to September 30th, 2019, using the terms infective endocarditis, diagnosis, and management to find the most pertinent and highest-quality evidence. This review summarizes key aspects of IE, with a focus on emerging advances in diagnosis. We also highlight growing patient populations at risk for IE, including patients with intracardiac devices and congenital heart disease.
感染性心内膜炎（IE）最初于 350 多年前被描述，涉及心脏的心内膜表面感染。IE 的临床表现可能涉及每个器官系统，心脏表现可包括瓣膜赘生物、脓肿、感染的瓣周延伸和心肌心包炎。超声心动图在 IE 的诊断中至关重要，但替代成像方式在 IE 的诊断和管理中发挥着越来越重要的作用。IE 的管理需要多学科的护理，通常需要心脏病专家、心胸外科医生、传染病专家、放射科医生和神经科医生的专业知识。我们在 PubMed 数据库中进行了一项从 2000 年 1 月 1 日至 2019 年 9 月 30 日的文献检索，使用术语感染性心内膜炎、诊断和管理来寻找最相关和最高质量的证据。这篇综述总结了 IE 的关键方面，重点介绍了诊断方面的新进展。我们还强调了感染性心内膜炎风险不断增加的患者人群，包括心脏内装置和先天性心脏病患者。
