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Blood culture is only 30% accurate due to several factors, including blood volume restrictions, timing of blood draw, antibiotic treatment, and viable organisms

Mechanisms identified include: increased cardiac utilization of ketones increased autophagy (recycling of intracellular components)l decreased inflammation & oxidative stress improved mitochondrial function decreased intracellular Ca & Na overload decreased fibrosis improved myocardial diastolic function decrease myocardial hypertrophy Figure 1

(7) Fortunately, a number of effective treatment options are available, many of which are minimally invasive

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In such cases, pharmacological intervention will be required

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