Infective Endocarditis in the Elderly: Challenges and Strategies

Journal of Cardiovascular Development and Disease

Mauricio Pellicer¹  Sergio García-Blas¹  Vicente Bodi¹  Clara Bonanad¹  Enrique Santas¹  Francisco Javier Chorro¹  Pablo Díez-Villanueva²  Jose-Angel Perez-Rivera³  Alberto Doménech⁴  Andreu Belmonte⁵  Ana Isabel de Gracia⁵  Carlos Bea⁵  Ana Ferrer⁵  Eladio Fuertes⁵  Sara Vela⁵  Maria Rosa Oltra⁵  Maria José Forner⁵  Javier Colomina⁶ 

[1] Servicio de Cardiología, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain;Servicio de Cardiología, Hospital Universitario La Princesa, 28006 Madrid, Spain;Servicio de Cardiología, Hospital Universitario de Burgos, 09003 Burgos, Spain;Servicio de Cirugía Cardiovascular, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain;Servicio de Medicina Interna, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain;Servicio de Microbiología, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain;

关键词: infective endocarditis;    elderly;    diagnosis;    treatment;   

DOI  :  10.3390/jcdd9060192

来源: DOAJ

【 摘 要 】

The specific management of infective endocarditis (IE) in elderly patients is not specifically addressed in recent guidelines despite its increasing incidence and high mortality in this population. The term “elderly” corresponds to different ages in the literature, but it is defined by considerable comorbidity and heterogeneity. Cancer incidence, specifically colorectal cancer, is increased in older patients with IE and impacts its outcome. Diagnosis of IE in elderly patients is challenging due to the atypical presentation of the disease and the lower performance of imaging studies. Enterococcal etiology is more frequent than in younger patients. Antibiotic treatment should prioritize diminishing adverse effects and drug interactions while maintaining the best efficacy, as surgical treatment is less commonly performed in this population due to the high surgical risk. The global assessment of elderly patients with IE, with particular attention to frailty and geriatric profiles, should be performed by multidisciplinary teams to improve disease management in this population.

【 授权许可】

Unknown