Clinical profile of major embolic complications in infective endocarditis at a tertiary care hospital in North India

Background: Embolism is a dreaded complication of Infective Endocarditis (IE). Embolism may cause an acute myocardial infarction (AMI). (Cecchi et al., 2004; Deprele et al., 2004) Neurological complications develop in 20-40% of cases, most of which are stroke or transient ischemic attacks. Central nervous system (CNS) involvement is most common; stroke comprises up to 65% of embolic events and may be the presenting sign of I.E. in up to 14% of cases (Jones and Sickert, 1989), Up to 90% of CNS emboli lodge in the distribution of Middle cerebral artery and carry a high mortality rate (Pruitt et al., 1978). Objectives: To study the major embolic complications in duke definite infective Endocarditis patients. Design: A Prospective hospital based study conducted over a course of three years on fifty consecutive cases of duke definite infective Endocarditis. Methods: Fifty patients of Infective Endocarditis (IE) were evaluated and studied for prevalence of major embolic complications during treatment in hospital and six weeks follow up. Results: Of the patients studied (n=50), 29 (58 %) were males and 21 (42 %) were females. Embolic complications were documented in 8 (16%) of patients: 3 (37.5%) had stroke, 3 (37.5%) had peripheral embolism most commonly to femoral and popliteal vessels and 2 patients developed embolic MI. Conclusions: Embolism is a common complication in IE, embolism most commonly involves CNS and peripheral vascular system. Coronary emboli may cause AMI.