Systemic Embolism in Endocarditis: Incidence, Risk Factors, Clinical Significance and Treatment Strategies

Systemic embolism remains a vexing problem in patients with infective endocarditis. This complication affects about 30 % of these patients and generally occurs in the early stage of the disease. The size of the vegetation is the best echocardiographic predictor of the embolic risk, but there is considerable overlap in vegetation size between patients with and without embolic events. Early cardiac surgery appears to reduce the risk of embolism in patients with large vegetations and severe valvular dysfunction. Prompt diagnosis and effective antibiotic therapy remain the best way to prevent this serious complication of endocarditis.