Noninvasive Detection of Cardiac Abscesses Complicating Infective Endocarditis

Abstract

Cardiac abscesses are a major complication of infective endocarditis and contribute significantly to morbidity and mortality. The frequency of this complication is unknown. For this reason, the Mayo Clinic experience is reviewed. During a 10-year period from 1976 to 1985, 334 patients were diagnosed as having infective endocarditis. Of these, 39 (12%) had cardiac abscesses. Of the 39 patients with cardiac abscesses, 11 (28%) had variable degrees of A-V block not attributable to digitalis. Thirty of thirty-nine patients had 2-dimensional échocardiographie (2-DE) studies. Of the 30 patients with échocardiographie studies, a cardiac abscess was detected in 7 of 17 patients (41%) with native valve endocarditis and 2 of 13 patients (15%) with prosthetic valve endocarditis. Magnetic resonance imaging identified 1 case of cardiac abscess. The indications for surgical intervention are persistence of infection despite appropriate antimicrobial therapy or deterioration of the patient’s cardiovascular status.