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Flashcards in Endocarditis Deck (13):
1

Endocarditis Definition

-inflammation of the lining of the heart
-typically involves the valves rather than the chambers, may also occur at the site of septal defects and patent ductus arteriosus
-vegetations occur on damaged valves

2

Conditions associated with risk of endocarditis

-previous valvulitis
-congenital heart lesions
-prothestic valve
-immune-suppressed, use of sterioids
-IV drug abusers
-Dental Work

3

Endocarditis 4 groups

-rheumatic
-atypical verrucous
-nonbacterial thrombotic
-infective

4

atypical verrucous

-accumulation of debris in the endocardium
-associated with lupus
-60-80% will show irregular, echogenic areas or masses located on valve surfaces
-vegetations may cause prolapse or flail valve

5

Non-Bacterial thrombotic endocarditis

-associated with malignancies
-similar to endocarditis however vegetations are small and located at base of leaflets
-clinical information needed for diagnos

6

Infective endocarditis etiology

-classic manifestation is vegetation
-common bacterial are streptococccus (effects damaged valves) and staphylococcus aureus (IV drug abusers, affects normal and damaged valves)
-two types acute and subacute
-aortic valve is most affected

7

History

-fever unknown origin
-postive blood cultures
-heart failure
-underlying heart disease
-recent invasive procedure
-flu like symptoms
-chest pains

8

Pathophysiology

-high velocity jets increase risk
-seeds on abnormal/normal valves and prosthetic valves
-organisms attach to the flow side of valves
-IV drug abusers at risk for TV vegetations

9

Physical Examination

-new valvular regurgitation
-skin lesions (Osler nodes: small red tender areas), Janeway lesions: painless red-blue skin lesions
-embolic event
-clubbing of nails

10

complications

-structural valve changes
-hemodynamic changes
-embolization
-neurological manifestations(stroke)
-heart failure due to sever regurg

11

2-D and M-Mode

-vegetations appear as areas of increased echoes
-oscillations of vegetations
-leaflet disruption
-vegetation has shaggy appearence
-premature MV closure (increased LVEDP)

12

Doppler

-presence of regurgitation
-DT < 140 msec with increased E/A ratio with severe aortic regurgitation
-high velocity flow may suggest a fistula
-valve perforation with color flow through body of a leaflet

13

Treatment

-prevention
-antimicrobial therapy
-anticolagulation (embolic event)
-TX for heart failure
-valve devredement