Flashcards in Infective Endocarditis Deck (21):
Infective endocarditis definition
An infection of the heart's inner surface.
Four groups of IE
Native Valve IE
Prosthetic Valve IE
Intravenous Drug Abuse IE
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
Most common pathogens for IE
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.
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.
Cardiac lesions that predispose to endocarditis
Rheumatic heart disease, other valvular lesions, HOCM, prosthetic heart valves.
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.
Symptoms of subacute IE
Nonspecific, flulike. Low grade fever, anorexia, fatigue, arthalgias, n/v.
When do symptoms usually start?
About 2 weeks after bacteremia.
Cardiac manifestations of endocarditis
New regurgitant murmurs. CHF, pericarditis, heartblock/mi from emboli.
Noncardiac symptoms of endocarditis
Petechial hemorrhages, Janeway Lesions, Osler Nodes, Roth Spots, Splinter hemorrhages, mycotic aneurysms, glomerulonephritis.
Linear reddish-brown lesions. Usually by nail bed. Non blanching.
Painful and erythematous nodules found near fingers and does. Painful, more common in subacute IE. Osler=ouch, raised.
Irregular discolorations founds on the palms and soles, nonblanching, nonpainful. Nonraised.
Microemboli in retina
How to diagnose IE
CBC, blood cultures, chest X-ray, EKG
How to treat IE
4-6 IV antibiotics, surgery.
Who is given prophyaxis for IE?
If prosthetic heart valves, prior history of IE