infective endocarditis Flashcards
define infective endocarditis
Infection of heart valve/s or other endocardial lined structures within the heart caused by bacteria
what 3 organisms cause infective endocarditis
S. aureus- most common
S. viridans
S. epidermis
what is the endocardium
thin, smooth interior lining of the heart covering the heart valves
signs of infection
fever
fatigue
loss of appetite
how many types of IE
17
risk factors for IE
male , elderly w/prosthetic valves
young IV drug user
young with congenital heart defect
RHEUMATIC HEART DISEASE
PATHOPHYSIOLOGY OF IE
abnormal/ damaged endocardium have increased platelet deposition thus bacteria adheres to this and causes vegetations
how would you catch IE
-Have an abnormal valve; regurgitant or prosthetic valves are most likely to get infected.
-Introduce infectious material into the blood stream or directly onto the heart during surgery
-Have had IE previously
Clinical presentation
-splinter haemorrhages
-osler nodes ( tender nodules in finger)
-janeway lesions (nodules on palms)
-roth spots (haemorrhage with clear centre on fundoscopy )
DUKE CRITERIA
2 major
1 major and 3 minor
5 minor
minor factors
1-predisposing factor
2-fever >38
3-immunologic features
4-vascular features
5- atypical blood cultures
major factors
lab evidence -typical agent in blood cultures
endocardial involvement ie positive echocardiogram
method to diagnose
Transthoracic echo cardiogram- safe , non invasive
why would you use an Transoesophegeal over TRANSTHORACIC
Excellent picture
used if patient has lung disease
Infective endocarditis arises from three key factors occurring simultaneously….?
Transient bacteraemia
Damage to valvular tissue
Formation of vegetations
