endocarditis Flashcards
test for endocarditis
blood cultures
risk factors for ICED infections
pre procedure prophylaxis complexity of procedure temporary paper use type of device number of revisions and reinterventions fever within 24 hours heart failure, renal failure haematoma post procedure
infective endocarditis
infection of the endothelium of the heart valves
life threatening - often late diagnosis
predisposing factors for endocarditis
heart valves abnormality
prosthetic heart valve
IV drug user
intravascular lines
endocarditis pathogenesis
heart valve damage
turbulent blood flow over roughened endothelium
platelets/fibrin deposited
bacteraemia may be transient
organisms settle in fibrin/platelet thrombi becoming a microbial vegetation
infected vegetations are friable and break off becoming lodged in the next capillary bed they encounter causing abscess or haemorrhage may be fatal
presentation of acute endocarditis
overwhelming sepsis and cardiac failure
usually due to aggressive organisms such as staph aureus
sub acute presentation
fever, malaise, weight loss, tiredness, SOB
new or changing heart murmur, finger clubbing, splinter haemorrhage, splenomegaly, roth spots, Janeway lesions, osler nodes, microscopic haematuria
prosthetic valve endocarditis
early - usually infected at time of insertion and usually due to staph epidermis or staph aureus
late - up to many years after valve insertion due to co-incidental bacteraemia
endocarditis in PWID
right sided tricuspid - mitral - aortic
usually staph aureus
treatment
bactericidal regimens
native valve - amoxicillin and gentamicin
prosthetic valve - vancomycin and gentamicin, valve replacement
PWID - flucloxacillin
myocarditis
fever, chest pain, SOB, palpitations arrhythmias, cardiac failure enteroviruses diagnosis by viral PCR, throat swab and stool supportive treatment
pericarditis
often occurs with myocarditis chest pain main feature viral aetiology supportive treatment bacteria less common
