Care of the Elderly Patient with Infective Endocarditis

Purpose of Review: This review analyzes the presentation, manifestations, and management decisions for elderly patients with infectious endocarditis (IE). Recent Findings: There are significant differences in IE across ages. Whereas the major risk factors for younger individuals include intravenous drug use and complex congenital heart disease, older adults tend to develop IE on prosthetic valves or in the setting of degenerative valve disease. Nosocomial disease is important regardless of age. The microbiology differs too for elderly patients. Although Staphylococcus aureus is universally an important pathogen, elderly patients are more likely to have IE from S. gallolyticus and Enterococci. New tools for risk stratification may better estimate true surgical risk for elderly patients with IE. Summary: The epidemiology of IE has shifted over the last several decades, making it increasingly a disease of the elderly, who tend to have worse outcomes. It is important to understand how IE manifests in elderly patients in order to manage it appropriately.