February 1, 2016 - Endocarditis Flashcards Preview

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Flashcards in February 1, 2016 - Endocarditis Deck (10):
1

Endocarditis

The inflammation of the inner layer of the heart, the endocardium

It usually involves the heart valves, but may also involve the septum, the chordae tendinae, the mural endocardium, or the surfaces of intracardiac devices.

Can be infective or non-infective.

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Infectious Endocarditis

Most often bacterial.

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Risk Factors for Infectious Endocarditis

Artificial valves

Intracardiac devices

Congenital heart disease

Rheumatic heart disease

Previous infective endocarditis

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Abnormal Cardiac Anatomy

75% of people who develop endocarditis have abnormal cardiac anatomy. This incldes congenitcal heart defects such as bicuspid aortic valve, mitral valve prolapse, rheumatic heart disease, or artificial heart valves.

25% of people who develop endocarditis have normal cardiac anatomy, but many of these in this group are IV drug users.

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Pathophysiology of Endocarditis

Bacteremia + Abnormal Structure = Endocarditis

Stasis along the side of the valves allows bacteria to settle.

Staphylococcus and streptococcus account for >80%

A image thumb
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Complications of Infective Endocarditis

Embolism

Mycotic aneurysms (from bacteria)

Heart failure (cardiac / valvular dysfunction)

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Symptoms of Infective Endocarditis

Fever

Night sweats

Heart failure symptoms

Back pain (spleen)

Fatigue

Weight loss

Rigours

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Physical Signs of Endocarditis

Endocarditis does not always have physical exam signs, in fact, it often does not. Be clinically suspicious of endocarditis.

Splenomegaly - 11%

Splinter hemorrhages (nails) - 8%

Conjunctival hemorrhage - 5%

Janeway lesions (painless) - 5%

Osler's nodes (painful) - 3%

Roth's spots (in retina) - 2%

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Treatment of Infective Endocarditis

It is extremely important to get blood cultures and an ID consultation.

Native infective endocarditis you treat with cidal drug therapy, echo monitoring, and heart failure therapy.

Prosthetic infective endocarditis you need an immediate surgical consultation and surgery along with cidal drug therapy.

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