The podcast explores the complexities of diagnosing and treating endocarditis, emphasizing the challenges beyond the Duke criteria. Risk factors such as IV drug use, hemodialysis, valvular heart disease, and endovascular hardware are highlighted, along with the varied clinical presentations of left- and right-sided disease. The discussion covers the importance of blood cultures, echocardiography (TTE and TEE), and advanced imaging techniques like CT scans and brain MRIs for accurate diagnosis. Empiric and definitive antibiotic therapies are detailed, stratified by native vs. prosthetic valves and specific organisms. Surgical indications, contraindications, and the critical need for addressing opioid use disorder in affected patients are also addressed, as well as the importance of avoiding TPA in stroke patients.
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