Clinical Assistant Professor of Medicine, Texas A&M University College of Medicine; Emergency Medicine Physician, CHI St. Joseph Regional Hospital, Bryan, TX.
Assistant Professor of Emergency Medicine, Uniformed Services University of the Health Sciences. Emergency Medicine Physician, Madigan Army Medical Center, Joint Base Lewis-McChord, WA.
Emerg Med Pract. 2020 Sep;22(9):1-24. Epub 2020 Sep 1.
Recognition of infective endocarditis in the emergency department continues to be a challenge, as its signs and symptoms can be subtle, laboratory results are limited, and it can involve or lead to many other serious conditions. With the increase in use of medical access devices, implantable cardiac devices, and the rise of intravenous drug use, the epidemiology of infective endocarditis is changing. Diagnostic imaging has evolved, and the use of point-of-care ultrasound and transthoracic echocardiography are critical in making an early diagnosis. This review provides a best-evidence approach to diagnostic strategies, antibiotic recommendations, and surgical treatment recommendations for infective endocarditis.
在急诊科，感染性心内膜炎的识别仍然是一个挑战，因为其体征和症状可能不明显，实验室结果有限，并且可能涉及或导致许多其他严重疾病。随着医疗接入设备、植入式心脏设备的使用增加以及静脉药物使用的增加，感染性心内膜炎的流行病学正在发生变化。诊断成像技术也在不断发展，床边超声和经胸超声心动图的使用对早期诊断至关重要。本文综述了感染性心内膜炎的诊断策略、抗生素推荐和手术治疗建议的最佳证据方法。
