9. Infective Endocarditis and AF Flashcards
What is endocarditis
inflammation of the inner layer of the heart
what are most cases of endocarditis due to
a microbial infection
true or false; any area that is exposed to turbulent blood flow can be affected by endocarditis
true
the microbial infection needs to get into the blood stream and so how does this occur
through an open wound
during dental or surgical procedure
by using an infected needle or illicit substance
what. are some risk factors for infective endocarditis
prosthetic valves
congenital heart defects
rheumatic heart disease
intravenous drug abuse
With infective endocarditis it is important to identify the microbial cause;
- what is the most common cause
- viridian’s streptococci (found in the mouth)
- stap aures (contracted from IV drug use into the skin)
- stap epidermis (likes prosthetic valvue)- thorugh valve surgery and IV catheter
can also get enterococcus faecalis and strep Boris from colorectal cancer or UC
true or false; blood cultures will grow fungal infections
FALSE; blood cultures will not grow fungal infections
what is the normal presentation of infective endocarditis
a new fever and a new murmur due to turbulent flow
an infection in the heart can dislodge and become watts known as septal emboli. What is it called when
a) it lodged in tech finger nails
b) it lodged in the palms or soles
c) in the eye
a) splinter haemorrhages
b) Janeway lesions
c) roth spots
what are Osler nodes
antigen-antibody complexes that are nodules found on the distal pads of the digits
what other non-specific is a sign of infective endocarditis
petechiae
blood culture negative infective endocarditis (BCNIE) occurs in up to 31% of all cases and this most commonly raised as a consequence of
previous antibiotic administration
hw do you diagnose infective endocarditis
the modified dukes criteria
need 2 major criteria OR
1 major and 3 minor criteria OR
5 minor criteria
Name the major criteria for diagnosing infective endocarditis
- Positive blood culture for IE: typical micro-organism consistent with IE from two separate blood cultures
- Evidence of endocardial involvement
- Positive echocardiogram for IE;
name the minor criteria for diagnosing infective endocarditis
- Predisposition: predisposing heart condition or IV drug use
- Fever: temperature greater than 38 degrees
- Vascular phenomena; major arterial emboli, septic pulmonary infarct, intracranial haemorrhage, conjunctival haemorrhage and Janeway’s lesions
- Immunological phenomena: glomerulonephritis, Osler’s nodes, Roth’s spots (eyes) and rheumatoid factor
- Microbiological phenomena: positive blood cultures but does not meet a major criterion as noted above or serological evidence of active infection with organism consistent with IE
- PCR: broad range PCR of 16S
- Echocardiographic findings consistent with IE but do not meet a major criterion as noted above
People who present with what common symptoms could have underlying AF
breathlessness/dysponea palpitations syncope/dizziness chest discomfort stroke/transient ischemic attack