6b. Infective Endocarditits Flashcards

1
Q

LOs

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is infective endocarditis?

A

Infection of endocardial surface of heart / valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

epidemiology of infective endocarditis

Incidence is rising possible as a result of…

A

6-7 per 100,000 every year, but may be rising:

  • Increasing no. of elderly with prosthetic or abnormal valves
  • Increasing number of invasive procedure so increased risk of bacterial infection in the heart
  • Increased number of children with CHD survive due to better management
  • Increased intravenous drug use -> dirty needles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

cause of endocarditis?

A
  • Usually bacterial, occasionally fungal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

morbidity and mortality %?

A

Significant morbidity and mortality (20-30%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
A

Most commonly runs an insidious course
known as subacute (bacterial) endocarditis
(SBE)
* Term ‘infective endocarditis’ preferred (IE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

aetiopathogenesis of infective endocarditis?

A

Endocarditis usually a consequence of
two factors:
- Abnormal cardiac endothelium facilitating bacterial adherence and growth (EG patients with prosthetic heart valves, congenital heart defects)
- Presence of organisms in the blood (known as bacteraemia)

~ Abnormal endothelium create non-laminar blood flow(Eddy Currents and Jet Streams), promoting fibrin and
platelet deposition
~ Small thrombi develop & allow organisms to
adhere and grow
~ Leads to characteristic infected vegetations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
A

Growing proportion of patients have no definable underlying cardiac lesion e.g.
- patients over 65 with minor degenerative lesions
- intravenous drug users with periodic introduction of foreign material who have undetectable lesions serving as a nidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is a nidus

A

area where bacteria thrive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

organisms involved in pathogenesis of infective endocarditis?

A

Streptococci 63%
Viridans group 50%
Staphylococci 26%
Fungi 4%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

why is the culture neg in approx 5-10% of patients

A
  • Possibly due to previous
    antibiotic therapy
  • Fastidious organisms that fail to
    grow in normal blood cultures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are fastidious microorganisms?

A
  • microorganisms that have complex or particular nutritional requirements
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

clinical features of infective endocarditis?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

investigations methods into infective endocarditis signs

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

treatment of infective endocarditis
- drug therapy
- surgery

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

prognosis is worse when?

A
  • Organism is unidentifiable
  • Cardiac failure present
  • Prosthetic valve infected
  • Microorganisms are resistant
17
Q

what is prophylaxis

A

action taken to prevent disease

18
Q

Prophylaxis – NICE Guidelines

A
19
Q

Prophylaxis – Patients’ at risk

A
20
Q

Prophylaxis – Patient Advice

A
21
Q

Summary Infective Endocarditis

A
22
Q

Dental relevance (from AZ notes)

A