Mr Roger Hall,
This excellent session covered four very important aspects of this difficult condition. Firstly the high incidence of healthcare associated endocarditis was emphasised by J Lopez Diaz - this is now more common than traditional IE and has a much higher mortality. Its rise seems to associated with more aggressive medicine and is particularly common in the USA. Prof Iung described the results of routine MRI scanning in IE. Head scanning shows a high incidence of asymptomatic cerebral problems including emboli, small bleeds and mycotic aneurysms. These findings were sometimes helpful in establishing the diagnosis of IE but did not have any prognostic significance. Routine abdominal scanning had no additional value. The group from Barcelona, represented by N Fernandez Hidalgo presented data on referral of patients with IE to a tertiary centre. The message was that referral was often unnecessarily delayed and that this delay leads to worse outcomes in patients who often had inherently less risky situations. Ways of speeding referral were discussed and these have been shown to be improving results. Finally Dr Prendergast analysed referral for surgery and emphasised the need for close liaison between all disciplines in achieving timely referral and the beneficial effect this has on survival.
Infective endocarditis: an ever changing disease
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