Right-Heart Endocarditis

  • Isidre VilacostaEmail author
  • Carmen Olmos Blanco
  • Cristina Sarriá Cepeda
  • Javier López Díaz
  • Carlos Ferrera Durán
  • José Alberto San Román Calvar


Right-heart endocarditis accounts for 5–12 % of cases of infective endocarditis (IE). We can distinguish four different types of right-heart endocarditis: IE in intravenous drug users (IVDU); IE in patients with pacemakers, implantable cardiac defibrillators or central venous catheters; IE in patients with right-heart congenital abnormalities, and IE in patients who are not IVDU, who have no implanted cardiac devices or other catheters, and who have no left-sided endocarditis, the so called “three noes” IE group. Diagnostic clinical features of right-heart IE include respiratory symptoms, S. aureus bacteremia, and fever of unclear origin. Transthoracic echocardiography is especially valuable in this scenario. Many IVDU with right-heart IE have a relatively benign clinical course and most of them may be conservatively managed. Nonetheless, 5–10 % of cases will still need surgery and in them a conservative approach is recommended. Recurrences are high in IVDU. Patients from the “three noes” group have more comorbidities, health care related infections, and higher mortality.


Right-sided endocarditis Intravenous drug users Antibiotic therapy Tricuspid valve surgery “Three-noes” endocarditis Echocardiography 


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Isidre Vilacosta
    • 1
    Email author
  • Carmen Olmos Blanco
    • 1
  • Cristina Sarriá Cepeda
    • 2
  • Javier López Díaz
    • 3
  • Carlos Ferrera Durán
    • 1
  • José Alberto San Román Calvar
    • 3
  1. 1.Department of CardiologyHospital Clínico San CarlosMadridSpain
  2. 2.Department of Internal Medicine and Infectious DiseasesHospital Universitario de la PrincesaMadridSpain
  3. 3.Instituto de Ciencias Del Corazón (ICICOR)Hospital Clínico Universitario de ValladolidValladolidSpain

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