Clinical profile of patients with mural infective endocarditis vs valvular endocarditis - Video

Infective endocarditis patients present very rarely with vegetations on the mural endocardium. There are very few studies that are available comparing Mural infective endocarditis with commoner valvular or device related infective endocarditis.

To analyse the clinical features, microbiological profile and clinical course of mural endocarditis in comparison to valvular endocarditis, the present study was published in Indian Heart Journal that revealed that mural endocarditis is equally riskier and fatal as that valvular endocarditis.

A retrospective analysis of data included Patients who were reported to have vegetations on the mural endocardial surface – these patients were taken as a group and compared with rest of the patients. Clinical profile, laboratory parameters including culture and outcomes were compared between the two groups.

Out of 278 patients in the study, 5.38% had vegetations on the mural endocardium. Of them, only 4 patients had structural heart diseases. Many aspects were compared between the two groups. It was found that ventricles were the commonest sites of vegetations. Inflammatory markers like ESR and CRP were low in mural endocarditis compared to rest. Culture positivity was high in mural endocarditis and Staphylococcus Aureus was the commonest organism. Mural endocarditis patients had similar in hospital mortality to rest of the patients. Cardiac complications were not reported in mural endocarditis, but they had similar incidence of embolic complications including neurological events.

So the researchers concluded that mural endocarditis is a rare clinical entity with similar morbidity and mortality to that of endocarditis with valvular vegetation.

Reference: Gopalan Nair Rajesh, Haridasan Vellani, et al; Clinical profile and one-year outcomes of patients with mural infective endocarditis: – A tertiary care centre study based on data from a seven-year registry, Indian Heart Journal, Volume 74, Issue 3,DOI:https://doi.org/10.1016/j.ihj.2022.05.003.