Profile of right-sided endocarditis: an Indian experience

Anil Grover, Inder S. Anand, Jagmohan Varma, Rajib Choudhury, Hari N. Khattri, Rajendra P. Sapru, Padmakar S. Bidwai, Purshotam L. Wahi

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20 Scopus citations

Abstract

The clinical profile of right-sided infective endocarditis in India was studied from a review of records of patients with infective endocarditis admitted to this hospital. From November 1982 to November 1989, 109 patients with infective endocarditis showed vegetations on cross-sectional echocardiography confirming the diagnosis of infective endocarditis. In 19 (17.4%) patients, only the right side of the heart was involved: specifically the tricuspid valve alone in 10; tricuspid and pulmonary valves in 4; tricuspid valve and right ventricular outflow tract in 1; tricuspid valve and right ventricular free wall in 1; pulmonary valve alone in 2; and bifurcation of pulmonary trunk in 1. Eleven patients (57.9%) had underlying congenital heart disease whereas the remaining 8 patients (42.1%) did not have any underlying heart disease. The latter group, therefore, had isolated right-sided infective endocarditis. Previous illnesses leading to isolated right-sided infective endocarditis were: puerperal sepsis in 4; septic abortion in 1; staphylococcal pneumonia in 2; and epididymoorchitis in one. Eight out of 11 patients with congenital heart disease did not report any previous illness. In the remaining 3, right-sided endocarditis followed cardiac surgery in one; dental extraction without prophylaxis in one; and pulmonary balloon valvoplasty in one. All patients with isolated right-sided infective endocarditis had features of septicaemia, but a murmur of tricuspid regurgitation was audible in only 4 (50%) of them. We conclude that, unlike western reports, the pattern of right-sided infective endocarditis in India is different. No drug addict with right-sided infective endocarditis was seen; puerperal sepsis and septic abortion were the commonest causes of isolated right-sided infective endocarditis. Despite the fact that rheumatic heart disease is very common in India, none of the cases had rheumatic heart disease.

Original languageEnglish (US)
Pages (from-to)83-88
Number of pages6
JournalInternational Journal of Cardiology
Volume33
Issue number1
DOIs
StatePublished - Oct 1991

Keywords

  • Infective endocarditis
  • Isolated right sided endocarditis
  • Puerperal sepsis

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