Clinical relevance of vegetations in infective endocarditis
Soni, D.; Dhawan, S.; Agarwal, S.; Chandra, N.; Chandra, P.; Dwivedi, S.; Puri, V.K.; Hasan, M.
Indian Heart Journal 43(5): 373-376
1991
ISSN/ISBN: 0019-4832 PMID: 1821000 Document Number: 379716
Two-dimensional echocardiograms of 58 patients with infective endocarditis were examined to determine if presence and/or size of vegetations on echocardiogram were predictive of morbidity and mortality. Group 1 (38 patients) with one or more vegetations, had a significantly higher rate of complications (emboli, congestive heart failure, need for surgery and death) than group 2 (20 patients) without vegetations (p less than 0.001). Analysis of morphologic characteristics of the vegetations in group 1 was of no predictive value for complications in individual patients. In contrast, patients whose echocardiograms demonstrated vegetations on aortic valve had a significantly higher incidence of heart failure, embolisation, surgery and death than those with vegetations on mitral valve. Thus, the detection of vegetations on initial echocardiogram clearly identifies a subgroup at risk for complications, more so if vegetations are present on the aortic valve, but the vegetations size does not predict an adverse clinical outcome.