Flashcards in Cardiovascular Diseases 3 Deck (99)
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1
Inflammation of the endocardium of the heart 'vegetations on valves'
Endocarditis
2
2 main types of endocarditis
Infective
Non-infective
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Describe the vegetations of infective endocarditis
mixture of thrombotic debris and organisms
destroy underlying cardiac tissue
4
What are the 2 types of infective endocarditis?
Acute and subacute
5
Which is caused by more virulent organisms, subacute or acute infective endocarditis?
Acute
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Describe the vegetations of acute infective endocarditis
Friable, bulky, potentially destructive vegetations. Ring abscess
7
Which is more easily treatable with antibiotics; acute or subacute endocarditis?
Sub-acute
8
Risk factors for infective endocarditis
Cardiac/valvular abnormalities
MV prolapse
Valvular stenosis
Artificial valves
Unrepaired congenital defects
Bicuspid AV
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Causative organisms of infective endocaridits
Streptococcus viridans
Staph A.
Coagulase -ve staphylococci
10
Which organisms can cause endocarditis, from prosthetic heart valves
Coagulase -ve staphylococci
11
Which organims can cause infective endocarditis from the mouth?
Streptococcus viridans
12
Clinical features of IE
Fever
Murmurs
Splinter haemorrhages
Janeway lesions
Oslers's nodes
Roth Spots
13
Erythematous or haemorrhagic non tender lesions on the palms or soles
Janeway lesions
14
Subcutaneous nodules in the pulp of the digits
Osler's nodes
15
Retinal haemorrhages in the eyes
Roth spots
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Complications of IE
Immunologically mediated conditions e.g. glomerulonephritis
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2 types of non infective endocarditis
Non bacterial thrombotic endocarditis (NBTE)
Libman Sacks endocarditis
18
In which patients do you get NBTE
cancer or sepsis.
a hypercoagulable state (DVT, PE and mucinous adenocarcinomas)
indwelling catheter lines
19
NBTE is part of what syndrome?
Trousseau syndrome of migratory thrombophlebitis
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Describe the vegetations if NBTE
Small, sterile thrombi on valve leaflets. Single or multiple on line of closure of leaflets or cusps.
21
What are the effects of NBTE
non invasive/no inflammatory reaction>minimal local effect
Systemic emboli infarcts in the brain, heart etc
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What type of endocarditis is associated with SLE
Libman Sacks
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What valves are affected in libman sacks endocarditis?
Mitral and tricuspid valves
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What are the effects of libman sacks endocarditis?
Usually asymptomatic, rarely cardiac failure or systemic emboli
25
Describe the vegetations of libman sacks endocarditis
Small (1-4mm), sterile, pink warty vegetations. Single or multiple
26
Rheumatic fever is an acute, immunologically mediated, multi-system inflammatory disease following what infection?
Group A steptococcal pharyngitis- causes scarlet's fever
27
What are the distinctive cardiac lesions, made up of T-cells, plasma cells and macrophages found in rheumatic fever?
Aschoff bodies
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What are the vegetations called in rheumatic fever?
Venuccae
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Pathological features of rheumatic fever
Vegtations (venuccae)
Mitral valve changes
Fish mouth or buttonhole stenoses- fibrous bridging of valvular commissures and calcification
30