**3. Physiopathology**

Infective endocarditis, especially when associated with prosthetic cardiac valves, carries a very high complication rate. Among the most dreaded complications are perivalvular abscesses, intracardiac fistulae, acute heart failure (typically from acute aortic insufficiency—a very poorly tolerated physiologic condition), complete heart block, septic emboli, and pseudoa‐ neurysms. In fact, embolic events occur in as many as 50% of all patients with infectious endocarditis. Specific organs and/or systems involved, from most to least common, include (A) central nervous system, 65%; (B) spleen, 20%; (C) hepatic, 14%; (D) renal, 14%; (E) muscu‐ loskeletal, 11%; and (F) mesenteric, 3% [1, 2].
