Buchele Endocarditis Flashcards
(38 cards)
What causes acute infective endocarditis? Where does it develop?
S. aureus
Develops on normal heart valve endothelium
What causes subacute infective endocarditis? Where does it develop?
- S. viridans and Enterococcus
- Develops on damaged heart endothelium
What is Marantic endocarditis, who is it seen in, and how is it found? (aka non bacterial thrombotic endocarditis)
- Develop on sterile platelet vegetations on cardiac valves
- Seen in patients with a metastatic malignancy
- Found on autopsy
What is Libman-Sacks endocarditis? Wo does it present in?
- Seen in patients with lupus
- sterile platelet vegetations on cardiac valves
How do those with Marantic and Libman Sacks endocarditis present?
- New cardiac murmur in setting of an embolic disease
Who does infective endocarditis effect?
- Older than 60
- Males
- IV drug use
- Poor dentition
- Structural heart disease
- Implanted cardiac device
How will an IV drug user with endocarditis present?
With right sided endocarditis due to S.aureus
What are the most common 3 pathogens of endocarditis?
- S. aureus
- S. viridans
- Enterococci
If you have a patient who has IE due to streptococcus bovis, what should you look for?
- Colon cancer or IBD
What are HACEK?
- Fastidious gram negative bacilli
- Haemophihlus
- Actinobacillus
- Cardiobacterium
- Eiknella
- Kingella
How will a patient with Infective endocarditis present?
- Fever >38
- Anorexia, weight loss, night sweats
- New cardiac murmur (usually regurgitation)
- Vascular embolic events
- Rarely:
- Oslers nodes
- Janeway lesions
- Roth spots
- Splinter hemorrhages
What are osler’s nodes?
Red raised painful lesions in distal extremeties
what is the modified duke criteria for diagnosing IE?
- Echocardiography
- Blood cultures (before abx)
clinical diagnosis of IE?
(dont need to memorize?)
- Major:
- positive blood culture
- persistent positive blood culture
- evidence of endocardial involvement via echo
- new regurgitation
- Minor:
- predisposition
- fever
- vascular phenomenon
- immunological phenomenon
- micro evidence
Cardiac complications of IE?
- HF
- Perivalvular disease
- Pericarditis
Metastatic infection complications of IE?
- Septic embolization
- stroke, paralysis, PE, renal infarct
- Metastatic abscess
- Meningitis
- Mycotic aneurysm
- Osteomyelitis
- Septic arthritis
Renal complications from IE?
- Septic embolization
- Glomerulonephritis with renal failure
Who gets endocarditis prophylaxis?`
High risk patients only:
- Hx of IE
- Hx of prosthetic valve replacement
- Hx of cardiac valve repair
- Hx of cardiac transplant with valvular regurgitation
- Congenital heart disease
- Dental procedures
What causes myocarditis?
- Idiopathic
- Viral infections
- Other organisms
What are the most common viral causes of myocarditis?
- Cocksackie B
- HHV6
- Parvovirus
How will myocarditis present?
- Recent viral infection
- Fever, myalgia
- Resp. or GI symptoms
- New or worsening HF
- Cardiac conduction abnormalities
- Acute myocardial infarction like syndrome
How do you dx myocarditis?
- Endomyocardial biopsy (EMB)
What images do you get for myocarditis?
- CXR
- ECG
- Echocardiography
- Cardiovascular magnetic resonance
What labs do you order/results expected for myocarditis suspicion?
- CBC with Diff
- Elevated ESR and CRP
- Elevated cardiac biomarkers
- Elevated BNP
