Infective endocarditis reflects infection of heart valves with echocardiographic evidence of noticeable complications in the form of vegetations or abscess formation. In recent years, there has been a change in the epidemiological profile of infective endocarditis, with an increase in valvular infection in elderly patients, often as a result of health care–associated procedures, both in patients with native valve disease and patients with prosthetic valves. In developed countries, the currently listed predisposing factors for endocarditis are degenerative valve sclerosis, valve prostheses, intravenous drug abuse, and frequent use of invasive procedures. In developing countries, however, where the prevalence of rheumatic fever remains high, rheumatic valve disease represents the main risk factor for infective endocarditis.