Pocket Guidelines on Endocarditis

Publication Date: 2023
Chairperson: Victoria Delgado and Michael Borger

Table of Contents

1. Introduction

2. Central concepts

3. Prevention

3.1. Population at risk of infective endocarditis

3.2. Situations and procedures at risk – Dental procedures

3.3. Patient education

4. The Endocarditis Team

5. Diagnosis

5.1. Clinical features

5.2. Blood culture-negative infective endocarditis

5.3. Imaging techniques

5.3.1. Echocardiography

5.3.2. CT, nuclear imaging and MRI

5.4. Diagnostic criteria

5.4.1. Modifications for the diagnosis of infective endocarditis

6. Prognostic assessment at admission

7. Antimicrobial therapy: principles and methods

7.1. Infective endocarditis due to oral streptococci and Streptococcus gallolyticus group

7.2. Infective endocarditis due to Staphylococcus spp

7.3. Blood culture-negative infective endocarditis

7.4. Empirical therapy

7.5. Outpatient parenteral or oral antibiotic therapy for infective endocarditis

8. Indications for surgery and management of main infective endocarditis complications

9. Other complications of infective endocarditis

9.1. Neurological complications

9.2. Heart rhythm and conduction disturbances.

9.3. Rheumatological manifestations

10. Surgical therapy: principles and methods

10.1. Pre-operative and peri-operative management – Coronary angiography

10.2. Surgical approach and techniques – Choice of valve prosthesis

10.3. Timing of surgery after ischaemic and haemorrhagic stroke

11. Outcome after discharge: follow-up and long-term prognosis

12. Management of specific situations

12.1. Prosthetic valve endocarditis

12.2. Infective endocarditis affecting cardiac implantable electronic devices

12.2.1. Device extraction

12.2.2. Device reimplantation

12.3. Right-sided infective endocarditis

12.4. Antithrombotic and anticoagulant therapy in infective endocarditis

13. Patient-centred care and shared decision-making in infective endocarditis

14. Sex differences