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18 Cards in this Set
- Front
- Back
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What is infective endocarditis?
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infection of the endocardial surface of the heart with microorganisms
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What part of the heart is most commonly affected?
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heart valves
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What kinds of bacteria are most likely to adhere to NBTE and cause infective endocarditis?
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Gram-positive (staph, strep, enterococci)
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When the valvular epithelium is damaged by abnormal blood flow, trauma (from device lead or on lead, etc), or valve abnormalities, ______________ and ____________ deposition occurs.
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platelet and fibrin
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The combination of this initial damage and the platelet-fibrin deposition forms what?
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Non-bacterial thrombotic endocarditis (NBTE) lesion
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Infective endocarditis is rare, but is most common in what group in the US?
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Elderly
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What symptom is almost always present in infective endocarditis?
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fever
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What kind of bacteria would result in acute infective endocarditis? Why?
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-Staphylococcus aureus
-it can adhere to healthy valve tissue without NBTE |
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What kind of bacteria would usually cause subacute IE?
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-Strep viridans
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4 skin manifestations of infective endocarditis
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-Osler nodes (painful, on fingers and toes)
-Petechiae -Splinter hemorrhages -Janeway lesions (palms and soles, non-painful) |
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T/F The absence of skin manifestations rules out the diagnosis of infective endocarditis.
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FALSE
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What two things should be ordered when suspecting infective endocarditis?
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-blood culture
-Echocardiogram |
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What are the two major criteria for infective endocarditis?
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-two positive blood cultures (showing sustained bacteremia)
-echocardiogram showing vegetations or a new regurgitation murmur |
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If you suspect IE caused by a HACEK organism, what would you do?
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-ask lab to hold blood cultures and do subcultures - they are slow, growing gram-negative bacteria
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What complication can result from IE of the aortic valve?
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-can grow into septum and cause conduction defects/complete heart block
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How is infective endocarditis treated with medical management? Why?
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-prolonged high dose IV antibiotics
-no vasculature to the vegetations so bacteria are protected, must get antibiotics there by diffusion |
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If medical management fails, what else can be done?
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surgical removal of the valve
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If infection occurs on a cardiovascular implantable electrical device (CIED), what is done?
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-remove device
-treat with IV abx -don't replace until infection is gone |
