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15 Cards in this Set
- Front
- Back
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What is the typical lesion of infective endocarditis?
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vegetation!
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Which valve does endocarditis strike most often?
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Pulmonary!
second place is tricuspid third aortic fouth mitral |
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What are the 4 cardinal manifestations of infectious endocarditis?
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1.acute valvulitis
2. persistent bacteremia 3. immunologic mediated vascular phenomena 4. large vessel emboli |
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Pathogenesis of Endocarditis
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1. endothelial injury- regurgitant jets on left sided valves, IVDA/Nosocomial/PM on right sided valves
2. formation of clot- platelet/fibrin clump, aka "non-bacterial thrombotic endocarditis" 3. deposition of microorganisms |
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What is non-bacterial thrombotic endocarditis?
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Formation of clot- platelet "clump"
usually small, endothelial injury without the deposition of microorganisms! |
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What is the main cause of native valve endocarditis?
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valvular heart disease (esp mitral valve prolapse)
immunocompromsed |
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What sort of valves tend to get infected in IV drug users? Why?
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predisposition to infect right sided valves (tricuspid)
also, more highly virulent organisms |
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What is the most important causative organism for infectious endocarditis?
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80% is due to Staph or Strep!
*Gram positive Strep! Think gram positives |
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What are the three main categories of clinical manifestations for infectious endocarditis?
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1. local growth/destruction
2. constitutional symptoms 4. peripheral manifestations (like embolitic phenomena) |
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Main constitutional Sx of infectious endocarditis
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Fever
Malaise Anorexia Back Pain |
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Fever, malaise, anorexia, back pain, frequently sick for weeks or months. heart problems?
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Infectious endocarditis
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What are Janeway lesions, and with what are they associated?
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painless spots on palms and soles, associated with embolic complications of infectious endocarditis
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What are osler's nodes, and with what are they associated?
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Osler's Nodes are painful, red lesions on the hands and feet
associated with immunologic mediation of infectious endocarditis |
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Are blood cultures and transesophageal echo sensitive for vegetation from infectious endocarditis?
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Blood cultures are positive 85-90%
Transesophageal echo sensitive for vegetations 85-90% |
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Therapy for endocarditis
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IV antibiotics (high concentrations for protracted period (6 wks)
Surgery- for when failure to clear infection, recurrent emboli, etc |
