Emergency Department Management of Infective Endocarditis-Associated Stroke (Stroke CME)

Points & Pearls Excerpt

• When caring for patients with suspected stroke, endocarditis should always be considered. See Table 1 for key elements of history for both endocarditis and stroke.
• Neurologic complications are the most common extracardiac manifestations in infec-tive endocarditis, occurring in 25% to 70% of cases.^26,45
• Risk factors for infective endocarditis include pre-existing valvular disease or valve replacement, healthcare utilization and instrumentation (25% of cases),¹¹ immunocompromised states, hypercoagulable conditions, and IV drug use.
• Complications of infective endocarditis include intracerebral hemorrhage (ICH), stroke, transient ischemic attack, septic venous sinus thrombosis, meningitis, encephalitis, vertebral osteomyelitis, seizure, encephalopathy, and others; acute ischemic stroke is the most common.^10,12-14