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Erschienen in: Current Geriatrics Reports 4/2017

17.11.2017 | Cardiovascular Disease in the Elderly (M Chen, Section Editor)

Care of the Elderly Patient with Infective Endocarditis

verfasst von: Eric A. Meyerowitz, Shireesha Dhanireddy

Erschienen in: Current Geriatrics Reports | Ausgabe 4/2017

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Abstract

Purpose of Review

This review analyzes the presentation, manifestations, and management decisions for elderly patients with infectious endocarditis (IE).

Recent Findings

There are significant differences in IE across ages. Whereas the major risk factors for younger individuals include intravenous drug use and complex congenital heart disease, older adults tend to develop IE on prosthetic valves or in the setting of degenerative valve disease. Nosocomial disease is important regardless of age. The microbiology differs too for elderly patients. Although Staphylococcus aureus is universally an important pathogen, elderly patients are more likely to have IE from S. gallolyticus and Enterococci. New tools for risk stratification may better estimate true surgical risk for elderly patients with IE.

Summary

The epidemiology of IE has shifted over the last several decades, making it increasingly a disease of the elderly, who tend to have worse outcomes. It is important to understand how IE manifests in elderly patients in order to manage it appropriately.
Literatur
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Zurück zum Zitat •• Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al. ESC Guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the European Society of Cardiology. Eur Heart J. 2015;36:3075–128. https://doi.org/10.1093/eurheartj/ehv319. This article contains the most recent guidelines and their evidence for diagnosis and management of infectious endocarditis. CrossRefPubMed •• Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al. ESC Guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the European Society of Cardiology. Eur Heart J. 2015;36:3075–128. https://​doi.​org/​10.​1093/​eurheartj/​ehv319. This article contains the most recent guidelines and their evidence for diagnosis and management of infectious endocarditis. CrossRefPubMed
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Zurück zum Zitat • Oliver L, Lavoute C, Giorgi R, Salaun E, Hubert S, Casalta JP, et al. Infective endocarditis in octogenarians. Heart. 2017;0:1–8. https://doi.org/10.1136/heartjnl-2016-310853. This recent and particularly well done prospective cohort study analyzes the different features of infectious endocarditis in elderly compared to younger patients. • Oliver L, Lavoute C, Giorgi R, Salaun E, Hubert S, Casalta JP, et al. Infective endocarditis in octogenarians. Heart. 2017;0:1–8. https://​doi.​org/​10.​1136/​heartjnl-2016-310853. This recent and particularly well done prospective cohort study analyzes the different features of infectious endocarditis in elderly compared to younger patients.
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Zurück zum Zitat • Olmos C, Vilacosta I, Habib G, Maroto L, Fernandez C, Lopez J, et al. Risk score for cardiac surgery in active left-sided infective endocarditis. Heart. 2017;103:1435–42. https://doi.org/10.1136/heartjnl-2016-311093. This fascinating and thorough article proposes a new risk score to determine cardiac risk for patients with left-sided IE. Of note it more accurately estimates risk for older patients who may have their surgical risk overestimated by other risk calculators. CrossRefPubMed • Olmos C, Vilacosta I, Habib G, Maroto L, Fernandez C, Lopez J, et al. Risk score for cardiac surgery in active left-sided infective endocarditis. Heart. 2017;103:1435–42. https://​doi.​org/​10.​1136/​heartjnl-2016-311093. This fascinating and thorough article proposes a new risk score to determine cardiac risk for patients with left-sided IE. Of note it more accurately estimates risk for older patients who may have their surgical risk overestimated by other risk calculators. CrossRefPubMed
Metadaten
Titel
Care of the Elderly Patient with Infective Endocarditis
verfasst von
Eric A. Meyerowitz
Shireesha Dhanireddy
Publikationsdatum
17.11.2017
Verlag
Springer US
Erschienen in
Current Geriatrics Reports / Ausgabe 4/2017
Elektronische ISSN: 2196-7865
DOI
https://doi.org/10.1007/s13670-017-0229-6

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