Clinical presentation and in-hospital outcomes of infective endocarditis patients in Tanta University Hospital: a 5 year experience

Background Despite advances in understanding risk factors, antibiotic therapy, and prophylaxis, infective endocarditis (IE) remains a serious and often fatal disease. However, early suspicion and diagnosis based on European Society of Cardiology modified Duke criteria, prompt initiation of empirical, targeted antibiotics, and timely surgical intervention when indicated can markedly improve outcomes and reduce major complications. Aim To screen IE patients at Tanta University Hospitals, focusing on demographics, symptoms, imaging, outcomes, and in-hospital course. Patients and methods A total of 150 patients diagnosed with IE Data were collected and analyzed between February and August 2024 through revision of the patients’ medical records. Results Our study had male sex predilection with a mean age of 39.3 years, with drug abuse being the most prevalent noncardiac risk factor, and pre-existing valvular heart disease was as regard cardiac risk factors. The majority of patients presented with fever, which was the most common clinical presentation, followed by dyspnea with higher NYHA classification (III-IV). Preserved ejection fraction was more dominant between the patients; only few cases had reduced or mildly reduced ejection fraction. There was significant association between incidence of major adverse clinical events and different variables as congestive heart failure, and left ventricle systolic function impairment, with significant P value less than 0.05. Conclusion IE still carries high risk morbidity and mortality. Early symptoms of the disease are often subtle and may be overlooked, leading to a delay between initial clinical signs and a definitive diagnosis. This delay can result in significant valvular damage, hemodynamic compromise, and reduced long-term survival. The larger size of mass, occurrence of left ventricle systolic dysfunction, hemodynamic instability, rupture chordae, prolapse, abscess, and abscess-related pathologies were associated with an increase rate of major adverse clinical events incidence. Medical therapy alone was insufficient in some patients, where surgical intervention was required to enhance the disease prognosis.