Contents


Preface

The diagnosis of endocarditis has evolved substantially over the years, and there are many reasons for this. Advances in medical imaging technologies, including echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI) combined with greater utilization of these modalities for the serial diagnosis and management of patients have allowed for improved diagnosis and understanding of various disease conditions. In addition, greater awareness of the problem, especially some of the contributing risk factors such as implantable cardiac devices, intravenous drug/substance abuse, and more advanced chronically ill and immunosuppressed patients, has contributed to a significant increase in the overall incidence

While the diagnosis of endocarditis has remained somewhat consistent over the years, the tools used to evaluate and manage patients have become more widely available, more accurate, and more precise. Because of the increased utilization of advanced imaging technologies on patients at all stages of life, many more patients are being diagnosed with potential infectious complications of their cardiac structures. This has resulted in a growing incidence of unusual, complex, and poorly

It is also becoming clear that the global increase in substance abuse, especially intravenous drugs and the use of 'dirty' needles or 'contaminated' drugs, has also increased the incidence of infectious problems. While the ethical implications of managing patients with long-standing substance abuse have been previously discussed, various chapters in this book address some of the practical aspects of management of infectious complications associated with 'right-sided problems. Historically, the established international guidelines have focused on the management of 'left-sided disease, namely, involving the aortic and/or mitral valves. However, with the increased incidence of 'right-sided pathology, mainly the tricuspid valve and less commonly the pulmonic valve, the technical aspects of management continued to evolve. Likewise, decision-making regarding indications, medical therapy, and goals of care continue to evolve and become incorporated into professional society

With the growing understanding of the incidence, risk factors, management, and overall pathophysiology of endocarditis, there is also the increasing recognition of a potential impact on a broader range of the patient population. For example, with advanced in-cancer therapies and the potential impact on the heart, there is also growing interest in the potential role that oncologic treatment has on the heart, either as a primary impact or a secondary process, such as an increased risk for structural abnormalities including infectious endocarditis, and the ability to distinguish between normal, abnormal, and abnormal from infectious complications versus non-infectious complications. Chapters in this text lend some insights and guidance into these evolving multi-disciplinary areas of cardio-oncologic care.

While the topic of endocarditis is extensive and a comprehensive review is far beyond the scope of a single project, it is the goal of this text to highlight some

of infections involving heart valves and other cardiac structures.

understood problems, all of which are discussed in this book.

guidelines.
