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Flashcards in Endocarditis Deck (16)
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1

Where is the inflammation in endocarditis?

Inflammation of the endothelial or inner layer of the heart (this endothelium is continuous with the heart valves)

2

What are the risk factors for developing infective endocarditis?

IV drug abuse
Male > female
Prosthetic valves
Dental work
Congenital heart diseases
Hypertrophic cardiomyopathy

3

Why does dental work increase risk of infective endocarditis?

The causal bacteria live in the mouth:
Poor dental hygiene followed by dental work which may cut the gum, exposing the blood vessels to the pathogen

4

What is vegetation?

Growth and colonisation of bacteria in the endocardium

5

What is the risk of vegetation?

Forms thrombus - can throw off emboli
Calcification - valve may become stenosed

6

What is the risk of thrombus forming from vegetation in the tricuspid valve?

PE - tricuspid valve related to pulmonary circulation

7

What is a potential complication of infective endocarditis if the valves are destroyed?

Heart failure

8

What complications may arise from vegetation from valves in the left side of the heart?

Embolus in brain, kidney, spleen etc

9

What signs may be seen in the hands that indicate endocarditis?

Oslers nodes
Splinter haemorrhages

10

What causes Osler's nodes and splinter haemorrhages?

Emboli that have travelled and become lodged in the peripheral circulation

11

What cardiac signs may be present O/E that indicate valve involvement in endocarditis?

New murmur
Reduced cardiac output
Arrythmias (mainly AV blocks)

12

What are Oslers nodes?

Painful, red, raised lesions found on the hands and feet

13

What is a Janeways lesion?

Flat, painless, red/blueish nodes found on palms and soles

14

What sign may be seen in the eyes in infective endocarditis?

Retinal haemorrhage

15

What is the clinical presentation of endocarditis?

Fever
Murmur
Janeway lesions, splinter haemorrhages, Oslers nodes

16

What are the Duke criteria for diagnosis?

Must have two of the following major criteria:
- two positive blood cultures for common microorganisms e.g. staph. aureus
- echocardiogram positive for endocarditis i.e. vegetations
- new murmur