Infective Endocarditis Flashcards
(42 cards)
What is infective endocarditis?
Infection of the endocardium and the valves, associated with significant morbidity and mortality due to cardiac and extracardiac manifestations
What makes normal heart valves more susceptible to bacterial colonization in infective endocarditis?
Damage to normal heart valves allows platelet and fibrin deposits on the damaged endothelium for bacterial adhesion
What are some causes of damage to heart valves that lead to infective endocarditis?
Degeneration, instrumentation, contact with solid particles from injection drug use
What is the susceptibility of prosthetic heart valves in infective endocarditis?
Prosthetic heart valves are susceptible to bacterial adhesion and biofilm formation
What is heart valve vegetation?
Irregular growths of microorganisms and cell debris forming a vascular mass attached to the valve
What complications can vegetations cause in infective endocarditis?
Valvular stenosis or regurgitation
What can occur if vegetations extend to the perivulvar area?
Formation of abscesses that induce heart block, most common with aortic valve
What are the embolic risks associated with left-sided vegetations?
Prone to forming emboli in systemic circulation
What are the embolic risks associated with right-sided vegetations?
Prone to forming emboli in pulmonary circulation
What does the acronym ‘I HAVE ABC’ represent in the context of infective endocarditis microorganisms?
Significant microorganisms of infective endocarditis: I HAVE ABC
HA: HACEK group (Haemophilius, aggregatibacter, cardiobacterium, eikenella, kingella)
V: Vridans group streptococci
E: Enterococcus spp.
A: Staphylococcus aureus
B: Streptococcus bovis
C: Coxiella burnetii
What are the common microorganisms causing infective endocarditis?
Most cases caused by Staphylococcus or streptococcus species
Which microorganism is commonly associated with infective endocarditis in drug users?
Staphylococcus aureus
What is the common flora associated with non-vegetative endocarditis (NVE)?
Oral flora, e.g., Virdans group streptococci
What microorganisms are typically involved in healthcare-associated infective endocarditis?
Staphylococcus aureus, enterococci
Which microorganisms are associated with prosthetic valve endocarditis (PVE)?
Staphylococcal species
What microorganisms are commonly found in culture-negative infective endocarditis?
Gram-negative HACEK group, coxiella, brucella, bartonella
What is the most common symptom of infective endocarditis?
Fever
What are other common symptoms of infective endocarditis? FROM JANE
F: Fever (most common symptom)
R: Roth spots: Red lesions with white or pale centres that form due to retinal haemorrhaging
O: Osler nodes: Tender raised, red-purple lesions on the hands or feet, usually near fingers and toes
M: Murmur: Either a new murmur or changing murmur eg. aortic regurgitation murmur
J: Janeway lesions: Non-tender, haemorrhagic lesions (bleeding into the skin) that occur mostly on the palms and soles on the thenar and hypothenar eminences
A: Anaemia
N: Nail-bed haemorrhaging (splinter haemorrhaging)
E: Emboli
What are Roth spots?
Red lesions with white or pale centres that form due to retinal haemorrhaging
What are Osler nodes?
Tender raised, red-purple lesions on the hands or feet, usually near fingers and toes
What does a murmur indicate in infective endocarditis?
Either a new murmur or changing murmur, e.g., aortic regurgitation murmur
What are Janeway lesions?
Non-tender, haemorrhagic lesions that occur mostly on the palms and soles
What is a common hematological finding in infective endocarditis?
Anaemia
What is nail-bed haemorrhaging also known as?
Splinter haemorrhaging
