Native Valve Endocarditis in Cardiac Patients Admitted to Cardiovascular Department of Shaheed Madani Hospital, Tabriz

Background - Infective endocarditis is a disease caused by the microbial infection of the endothelium, which covers the inner layer of the heart. Different studies in advanced countries have reported the incidence of the disease from 1.6 to 6 in 100,000 patients. Methods - This retrospective analysis was conducted at Shaheed Madani Hospital of Tabriz between 1995 and 1999. The patients who lacked diagnostic symptoms of endocarditis, and those who were diagnosed on the basis of clinical signs were excluded from the study, and 20 patients who had endocarditis of the native valves were studied. The information was collected through a questionnaire including demographic information, blood samplings, pathologic results, reports of echocardiography and radiology, feverish syndromes, records of antibiotic use, and the signs of disease. Information was analyzed using the statistical program of SPSS WIN.Results - Twenty patients at an average age of 34 years with native valve endocarditis were selected for the study. 65% of these patients were male and 35% were female, and 17 patients had complete results of their blood culture test. Staphylococcus aureus was obtained in 11.67% of the cases, and two cases were positive for beta-hemolytic streptococcus (11.72%). In the analysis of cardiac complications, none of the patients had myocardial infarction and angina, 6 cases had embolism, 10% had no arrhythmias, and another 10% had heart block. Three of the patients had neurologic lesions, and radiological findings in 9 cases were abnormal. Eleven patients underwent open-heart surgery. The minimum duration of hospitalization was 6 days and the maximum 94 days. 80% of the patients recovered, while 20% died. Three patients had Brucella endocarditis, which was diagnosed via the Wright test. The most common site of infection was the aortic valve. Conclusion - Rheumatic fever is a universal disease, the outbreak of which is very high in the countries which have poor economic conditions, are overpopulated, and have substandard living conditions. These conditions cause the rapid transmission of rheumatogenic streptococcus. Improving these conditions and proper and timely antimicrobial treatment can decrease the prevalence of rheumatic fever as well as endocarditis (Iranian Heart Journal 2008; 9 (1): 22-28).