Arq. Bras. Cardiol. 2021; 117(4): 775-781

Infective Endocarditis in the Elderly: Distinct Characteristics

Luiz Henrique Braga Lemos, Leonardo Ribeiro da Silva, Marcelo Goulart Correa , Wilma Golebiovski, Clara Weksler , Rafael Quaresma Garrido, Giovanna Ferraiuoli Barbosa, Cristiane da Cruz Lamas

DOI: 10.36660/abc.20201134

Introduction

Infectious endocarditis (IE) is a serious disease with a mean in-hospital mortality of 20%. ^– It has shown an increasing incidence, and the rise in its prevalence among the elderly population deserves to be highlighted. ^– In elderly patients with IE, there are differences regarding the clinical presentation, complications, presence of comorbidities, therapeutic approach and mortality. ^{, –} IE guidelines do not specifically address the elderly population and it is not clear to what extent they can be appropriately used in these patients. ^{, ,} The elderly population has clearly benefited from medical progress, with diagnostic-therapeutic techniques that influence the increase in life expectancy and less invasive procedures. One example is the transcatheter aortic valve implantation in the management of aortic valve diseases. However, these procedures, together with the increasing implantation of cardiovascular electronic devices (CED) contribute to infections such as IE. Comorbidities are found in more than half of the elderly, with the consequent need for long-term care from health professionals, which increases the probability of acquiring IE. ^, The diagnosis of IE in the elderly is often delayed or forgotten. Manifestations may be nonspecific, attributed to aging and other conditions. Fever may be absent, with the presence of mental confusion only. IE can present with complications similar to those of other conditions, such as heart failure (HF), cerebrovascular accident (CVA) or systemic embolism attributable to atrial fibrillation. ^, In Brazil, despite a growing elderly population, to date there is no published article about IE in this group. The aim of our study was to describe the elderly group in our adult IE cohort and compare them with non-elderly individuals, highlighting the differences between the groups.

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