Infective Endocarditis Flashcards Preview

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Flashcards in Infective Endocarditis Deck (21):
1

Infective endocarditis definition

An infection of the heart's inner surface.

2

Four groups of IE

Native Valve IE
Prosthetic Valve IE
Intravenous Drug Abuse IE
Nosocomial IE

3

Acute vs Subacute IE

Acute: Affects normal heart valves, rapidly destructive, metastatic foci. Normally Staph! Can be fatal in 6 weeks.

Subacute: Affects damaged heart valves, indolent nature, fatal in 1 year. Usually Strep viridans

4

Most common pathogens for IE

S. Aureus
S. Viridans

5

How does IE occur?

Turbulent blood flow causes injury to endocardium. Thrombus forms at endocardium. Bacteria enter bloodstream. Bacteria adhere to the injured endocardial surface.

6

How does thrombus formation promote infection?

Process called Nonbacterial thrombotic endocarditis. Gives bacteria a place to latch on to OR can cover existing microbes to protect them from host defenses.

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Cardiac lesions that predispose to endocarditis

Rheumatic heart disease, other valvular lesions, HOCM, prosthetic heart valves.

8

Symptoms of acute IE

High grade fever and chills, SOB, arthralgias, abdominal pain, pleuritic chest pain, back pain. Unmistakable. These symptoms are serious ad explosive.

9

Symptoms of subacute IE

Nonspecific, flulike. Low grade fever, anorexia, fatigue, arthalgias, n/v.

10

When do symptoms usually start?

About 2 weeks after bacteremia.

11

Cardiac manifestations of endocarditis

New regurgitant murmurs. CHF, pericarditis, heartblock/mi from emboli.

12

Noncardiac symptoms of endocarditis

Petechial hemorrhages, Janeway Lesions, Osler Nodes, Roth Spots, Splinter hemorrhages, mycotic aneurysms, glomerulonephritis.

13

Splinter hemorrhages

Linear reddish-brown lesions. Usually by nail bed. Non blanching.

14

Osler's Nodes

Painful and erythematous nodules found near fingers and does. Painful, more common in subacute IE. Osler=ouch, raised.

15

Janeway Lesions

Irregular discolorations founds on the palms and soles, nonblanching, nonpainful. Nonraised.

16

Roth spots

Microemboli in retina

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How to diagnose IE

CBC, blood cultures, chest X-ray, EKG

18

Duke Criteria

A bunchashit

19

How to treat IE

4-6 IV antibiotics, surgery.

20

Who is given prophyaxis for IE?

If prosthetic heart valves, prior history of IE

21

When are these patients given the prophylaxis?

During manipulation of gingival tissue, upper respiratory tract