S. Rodbard, M.D., F.A.C.P.
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Analyses of pathologic findings in infective endocarditis, as well as of hydraulic and bacteriologic studies, suggest that this process occurs only at sites where high pressure gradients extrude blood at high velocities through narrow orifices. Thus, involvement occurs only on the ventricular surfaces of insufficient aortic valves, on the atrial surfaces in mitral insufficiency, and beyond the narrowings of coarctations and of arteriovenous fistulae. Initial vascular injury is not a prerequisite. Endocarditis never occurs at large openings, such as atrial septal defects or a widely patent ductus, since the pressure gradient is not present and high velocities do not occur.
Rodbard S. Hydraulic Mechanisms in Endocarditis.. Ann Intern Med. ;54:1039. doi: 10.7326/0003-4819-54-5-1039_2
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Published: Ann Intern Med. 1961;54(5):1039.
Cardiology, Endocarditis, Infectious Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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