Embolic Events And Neurological Complications In Infective Endocarditis

Infective endocarditis (IE) is an infection of the endocardial surface of the heart. The intracardiac effects of this infection include severe valvular insuffi ciency, which may lead to congestive heart failure and many complications. Valvular infections have entered the era of IE caused by increased usage of intravascular devices and medical procedures. Typically, the diagnosis is made relatively late, compared to the onset of valvular infection. Complications of infective endocarditis result from embolization, slowly progressive valvular destruction and various immunological mechanisms. Complications are very frequent in IE, complicating 20–60% of cases of IE. Th e risk of embolism is the highest during the first 2 weeks of antibiotic therapy and is clearly related to the size and mobility of the vegetation. Risk is increased with large vegetations (>10 mm) and particularly high with very mobile and even larger vegetations (>15 mm). Neurological complications develop in 20–40% of all patients with IE and are mainly the consequence of embolization. Rapid diagnosis and initiation of appropriate therapy especially antibiotics are of major importance to prevent a first or recurrent neurological complication.