Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
37 Cards in this Set
- Front
- Back
What is valvular endocarditis?
|
--inflammation of the valve tissue >> bacterial endocarditis >> vegetative endocarditis >> fungal endocarditis >> marantic endocarditis (sterile vegetations) |
|
Who gets mural endocarditis? What is it? |
--camelids get mural endocarditis --vegetations are on the walls, not the valves |
|
Pathogenesis of endocarditis: composition of lesions? |
--bacteremia --vegetative lesions >> wide variation of size/shape |
|
Endocarditis lesions consist of? |
--consist of platelets, fibrin, RBCs, WBCs, +/- admixed bacteria |
|
What is the injury-thrombus-infection theory? |
--must have transient or persistent bacteremia --endothelial injury results in platelet deposition --bacteremia allows bacterial adhesion/colonization of vegetative lesion |
|
Mitigating factors for endocarditis? |
--endothelial integrity --disturbed blood flow --bacterial virulence --host immunity |
|
Valve predisposition for endocarditis?
>> dogs, cats, horses, pigs? >> most ruminants? >> camelids? |
--dogs, cats, horses, pigs: mitral and aortic valves --tricuspid and pulmonic valves --mural endocardium (RV > LV) |
|
Pathophysiology of endocarditis? |
--valvular insufficiency >> volume overload --myocarditis >> arrhythmias --systemic infection >> sepsis --septic embolization (target organs) --immune-mediated disease >> arthritis, glomerulonephropathy |
|
Myocarditis arrhythmias secondary to endocarditis? |
-- ventricular arrhythmias > SVT > 3rd degree AV node block > atrial fibrillation |
|
Dogs with ____ ____ ____ are predisposed to infectious endocarditis. Why? |
--subaortic stenosis >> jet lesions on endocardial surface |
|
Predisposing factors for endocarditis? |
--subaortic stenosis --immunocompromise (e.g. chemo) --virulent infections >> diskospondylitis, prostatitis, pneumonia, UTI, pyoderma --indwelling catheters >> iatrogenic phlebitis |
|
Common bacteria involved in endocarditis in dogs? |
--staph --strep --E. coli |
|
Common bacteria involved in endocarditis in cattle? |
-- corynebacterium spp. |
|
Common bacteria involved in endocarditis in horses? |
--streptococcus spp. --actinobacillus spp. |
|
Culture negative endocarditis: reasons? |
--Bartonella spp. --other fastidious or slow-growing organisms --prior antibitic treatment --deficient blood culture technique |
|
What percentage of endocarditis cases will culture negative? |
-- 25%
|
|
Clinical signs of endocarditis? |
"the great imitator" --CHF, heart murmur --weight loss, diarrhea, anorexia --ocular disease, paresis, seizures --hematuria, renal failure --septic arthritis |
|
Signalment of dogs with endocarditis? |
--medium to large breed dogs --GSD, Boxers, Goldens, Labs, rottweilers >> breeds predisposed to subaortic stenosis |
|
Typical presentation of endocarditis? |
--4d anorexia lethargy --2d intermittent left pelvic limb lameness --24h respiratory difficulty --2/6 left basilar diastolic murmur -- 104.5F --bounding femoral pulses >> systolic P inc. >> diastolic P dec. |
|
Presumptive diagnosis of endocarditis: major criteria? |
--positive echocardiogram --new valvular insufficiency --positive blood culture |
|
Presumptive diagnosis of endocarditis: minor criteria? |
--fever --medium to large dog --SAS --thromboembolic disease --immune-med disease --positive blood culture --Bartonella serology > 1:1024 |
|
Definitive diagnosis?
|
--pathology of valve --two major criteria --one major and two minor criteria |
|
Gold standard diagnosis of endocarditis?
|
--isolation of bacteria from valvular lesion |
|
Blood culture technique? |
--multiple venipuncture sites >> 2-3 samples drawn over 3-24h >> sterile collection >> anaerobic and aerobic cultures >> do prior to abx if possible --antibiotic sensitivity testing |
|
Most cats with infectious endocarditis present with? Prognosis? |
--clinical signs of L CHF --not uncommon to have signs of ATE/inflammatory arthritis --grave prognosis, MST of 31 d (one study) |
|
Is there a correlation between dental disease and bacterial endocarditis in dogs? |
--no |
|
Acute bacterial endocarditis therapy? |
--aminoglycosides (amikacin) or enrofloxacin --penicillin or cephalosporin |
|
Chronic bacterial endocarditis therapy? |
--broad spectrum (C&S results) --long-term: 8-12 wks of treatment --heart failure treatment (FAD) --treat arrhythmias, target organ disease |
|
Chronic bacterial endocarditis therapy for culture negative? |
--clavamox and enrofloxacin |
|
Chronic bacterial endocarditis therapy for bartonella? |
--b-lactam --doxycycline --azithromycin |
|
Sites of embolization? |
--spleen --kidney --brain --heart --joints |
|
Prognosis of vegetative endocarditis? |
--guarded to poor |
|
Likely outcomes of vegetative endocarditis? |
--heart failure >> aortic insufficiency >> mitral regurgitation --septic shock --organ failure --cardiac arrhythmias -- >80% mortality (AI >> MR) |
|
Dogs with vegetative endocarditis fare better if?
|
--they have mitral regurgitation (not aortic insufficiency) and non-bartonella infections |
|
Mitral valve MST ___ Aortic valve MST. |
-- mitral valve MST > Aortic valve MST |
|
Sequelae of endocarditis? |
--valvular insufficiency --succumb to infection (sepsis) --embolization --arrhythmias --immune mediated complications |
|
Prophylactic treatment for dogs with SAS? |
--antibiotics prior to and after dental procedures, urogenital or GI surgery, other surgical procedures or lacerations |