Cardiac Infections Flashcards
What is the main cause of myocarditis?
enteroviruses
What is the meaning of dehiscence?
rupture
What is the specific treatment for Staph. aureus (MSSA) endocarditis?
IV flucloxacillin
What is used to diagnosis infective endocarditis?
two separate positive blood cultures and an echocardiogram
What is microscopic haematuria?
red blood cells in urine, dipstick test
What are the symptoms of myocarditis?
fever, chest pain, dyspnoea, palpations
What is the specific treatment for MRSA endocarditis?
IV vancomycin and IV gentamicin, oral rifampicin after 3-5 days
What are Janeway lesions?
non-tender lesions on palms or soles
What is the pathogenesis of infective endocarditis?
heart valve damaged - turbulent blood flow over roughened epithelium - platelets/fibrin exposed - bacteraemia - organisms settle in fibrin/platelet thrombi - become a microbial vegetation - friable - break off - lodge in capillary bed - abscess or haemorrhage
What are the symptoms of infective endocarditis?
fever, malaise, weight loss, tiredness, dyspnoea
What is the empirical treatment for prosthetic valve endocarditis?
IV vancomycin and IV gentamicin, oral rifampicin after 3-5 days
What is the specific treatment for Viridans strep. endocarditis?
IV benzylpenicillin and IV gentamicin (synergistic)
What is the echocardiographic evidence of infective endocarditis?
valvular lesions, vegetation, abscess, new partial dehiscence of a prosthetic valve
What cardiac infection is a cause of sudden death?
myocarditis
What are the signs of myocarditis?
arrhythmias, cardiac failure
What cardiac infection is more common in young people?
myocarditis
What is myocarditis?
inflammation of heart muscle
What is the main cause of pericarditis?
viruses
What are Roth spots?
retinal haemorrhages with white or pale centres
What is the specific treatment for Staph. epidermis endocarditis?
IV vancomycin, IV gentamicin and oral rifampicin
What is infective endocarditis?
infection of the endothelium of the heart valve, usually left sided
What is the specific treatment for Enterococcus sp. endocarditis?
IV amoxicillin/vancomycin and IV gentamicin
What are the signs of infective endocarditis?
fever, new/changing heart murmur, finger clubbing, splinter haemorrhages, Roth spots, Janeway lesions, Osler nodes, microscopic haematuria
What are the symptoms of pericarditis?
chest pain
What does pericarditis often occur with?
myocarditis
What can cause bacteraemia?
dental treatment
What is associated with endocarditis in PWID?
septic pulmonary emboli
When does early prosthetic valve endocarditis occur?
within 60 days of insertion
What is the most common cause of endocarditis in PWID?
Staph. aureus
What are the risk factors for infective endocarditis?
heart valve abnormality, prosthetic heart valve, PWID, IV lines
What is the empirical treatment for endocarditis in PWID?
IV flucloxacillin - usually MSSA
What side of the heart is affected in endocarditis in PWID?
right
What are the most common causes of early prosthetic valve endocarditis?
Staph. epidermidis or aureus
What is the empirical treatment for native valve endocarditis?
IV amoxicillin and IV gentamicin - usually Viridans strep.
How is myocarditis diagnosed?
viral PCR, throat swab and stool for enterovirsues, throat swab for influenza
How is endocarditis treated?
IV antibiotics for 4-6 weeks, monitor cardiac function, temperature and CRP, if falling on antibiotics refer for surgery early
What is the treatment for myocarditis?
supportive treatment
What are Osler nodes?
painful, red lesions on hands and feet
What are the common organisms that cause infective endocarditis?
Viridans strep., Staph. aureus, Enterococcus sp., Staph. epidermidis
What is the most common cause of infective endocarditis?
Staph. aureus
What is the most common cause of infective endocarditis associated with poor dental hygiene or after dental procedures?
Strep. viridans
