Changing concepts in management of infective endocarditis.

Sixty-four patients were treated for 73 episodes of infective endocarditis over the five-year period 1970 to 1974 at St Vincent's Hospital, Sydney. There were 13 deaths with a mortality rate of 18-1% compared with 38% (1950 to 1959). Included were 13 cases of infection on prosthetic valves with three deaths. Fifty-one per cent of patients were studied by cardiac catheterization. Early or emergency surgery was performed in 28% of cases and late surgery in 16%. The improved results were due to multiple factors, including early diagnosis, prompt investigation in a specialized unit, rational use of appropriate antibiotics, careful management of complications and early surgery.