Diagnosis and Management of Endocarditis in Older Adults

Christopher B. Johnson, MD, FRCPC, University of Ottawa Heart Institute, Ottawa, ON.

Older patients have a high prevalence of heart valve disease and prosthetic heart valves, and are therefore at particularly high risk for endocarditis. Streptococcus viridans and Staphylococcus aureus are the most common pathogens in older patients with endocarditis. While antibiotics may cure endocarditis, surgery is required on occasion to treat complications of endocarditis such as heart failure due to valvular regurgitation, systemic and cerebral emboli, and persistent bacteremia. Endocarditis can be accurately diagnosed in aging patients using clinical, microbiological, and echocardiographic criteria. Early diagnosis and prompt institution of antibiotic therapy can result in excellent outcome among older patients with endocarditis.

Key words: endocarditis, older adults, echo, heart valve, bacteria.