Bob,
Maybe I'm looking at this too simplistically. Once you have had infective endocarditis there has been damage done to the valve. That damage if undetected leaves a valve vunerable to calcification or another infection. Excuse my French...but either way you're screwed once you've had a bout of endocarditis extensive enough to cause damage to your valve. Some patients are diagnosed with subacute IE early, treated agressively and surgery is not recommended. But IMO the damage has been done and it's just a matter of time before the valve deteriorates or endocarditis sets in again. I have no idea what the stats are, but I'm guessing that most patients whose IE has progressed to the stage of vegetations being present will ultimately need their valve replaced. My main point is that IE that has progressed to the state that vegetations are present most likely will not survive without aggresive IV antibiotic treatment and/or surgery. I guess it is possible that an oral regimen of antibiotic treatment may kill off the vegetations but I find that highly unlikely. The more likely scenerio is that the patient will either continue to present more serious symptoms or a piece of the vegetation will break off and possibly cause catastrophic damage. I guess I'm unfamiliar with IE that doesn't reach the stage of vegetation and then subsides on its own. IMO it's the vegetation that would cause damage suffecient to allow calcification to form where the vegetations left further malformations of the valve. I honestly don't know enough about it to back up my statements...maybe it's possible to grow vegetations and have them subside without IV antibiotics. In that case the damage they left would be a perfect breeding ground for calcifications to form. And in the past maybe this scenario would be more likely. All I know is although I had subacute IE my health took a slow but steady downward turn that IMO would have ended in death had it not finally been diagnosed.
Maybe I'm looking at this too simplistically. Once you have had infective endocarditis there has been damage done to the valve. That damage if undetected leaves a valve vunerable to calcification or another infection. Excuse my French...but either way you're screwed once you've had a bout of endocarditis extensive enough to cause damage to your valve. Some patients are diagnosed with subacute IE early, treated agressively and surgery is not recommended. But IMO the damage has been done and it's just a matter of time before the valve deteriorates or endocarditis sets in again. I have no idea what the stats are, but I'm guessing that most patients whose IE has progressed to the stage of vegetations being present will ultimately need their valve replaced. My main point is that IE that has progressed to the state that vegetations are present most likely will not survive without aggresive IV antibiotic treatment and/or surgery. I guess it is possible that an oral regimen of antibiotic treatment may kill off the vegetations but I find that highly unlikely. The more likely scenerio is that the patient will either continue to present more serious symptoms or a piece of the vegetation will break off and possibly cause catastrophic damage. I guess I'm unfamiliar with IE that doesn't reach the stage of vegetation and then subsides on its own. IMO it's the vegetation that would cause damage suffecient to allow calcification to form where the vegetations left further malformations of the valve. I honestly don't know enough about it to back up my statements...maybe it's possible to grow vegetations and have them subside without IV antibiotics. In that case the damage they left would be a perfect breeding ground for calcifications to form. And in the past maybe this scenario would be more likely. All I know is although I had subacute IE my health took a slow but steady downward turn that IMO would have ended in death had it not finally been diagnosed.
