Infective endocarditis in adults in Glasgow, 1976-81.

Seventy-one cases of endocarditis in adults, defined on strict clinical criteria over a period of 5 years were studied. The demographic profile was similar to other published studies except that no bimodal peak in age distribution was detected. The major presenting features were infection, cardiac failure and embolism. Rheumatic valvular disease (44%) was the most common predisposing condition. Twenty percent of our patients developed endocarditis on an apparently normal valve and 28% presented with prosthetic valve infection. M-mode echocardiography was carried out in only 44% of cases and with a low rate of detection of vegetations. Streptococcus viridans was the most common causal organism. The mortality for the total series (45%) was considerably greater than that in other recent reports. Our study confirmed that failure to show early response to appropriate antimicrobial therapy was an indication to consider immediate valve replacement.