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Cardiovascular > Cardiac Infections > Flashcards

Cardiac Infections Flashcards

1
Q

Define bacteraemia

A

presence of bacteria in the usually sterile blood

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2
Q

Do all positive samples matter?

A

No - some may be due to contaminants

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3
Q

Name four skin organisms

A
  • staph aureus
  • staph epidermidis
  • corynebacterium sp
  • propionibacterium acnes
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4
Q

What are biofilms?

A

community of slow moving organisms that coat the device

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5
Q

State the risk factors for post ICD infection

A
  • pre procedure prophylaxis
  • complexity of procedure
  • temporary pacer use
  • type of device
  • number of reinterventions
  • fever within 24hours of procedure
  • heart & renal failure
  • haematoma post procedure
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6
Q

In an ICD what are the two main sites of infection?

A

generator pocket & lead infections

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7
Q

How will generator pocket infections present?

A

wound breakdown, discharge, swelling, discharge

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8
Q

How will lead infections present?

A

non-specific signs, fever, chills, night sweats, anorexia

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9
Q

Name the criteria used to assess endocarditis diagnosis

A

Duke’s Criteria

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10
Q

When should blood cultures be taken?

A

Before antibiotics (within an hour in septic shock)

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11
Q

Name four predisposing factors to infective endocarditis

A
  • heart valve abnormalities
  • prosthetic heart valve
  • IV drug users
  • IV lines
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12
Q

Describe the pathogenesis of infective endocarditis

A
  1. Damaged heart valve
  2. Turbulent flow over roughened endothelium
  3. Platelet/fibrin deposits
  4. Organisms settle in the platelet becoming vegetation
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13
Q

What happens to the microbial vegetations?

A

They break off and become lodged in the capillary bed causing abscesses or haemorrhage usually in the left side of the heart

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14
Q

What is the exception to the left being the common side?

A

Drug users - usually the right

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15
Q

Name a type of bacteria usually associated with bowel pathology

A

Strep gallolyticus

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16
Q

How many blood cultures should be taken?

A

3 sets of 2

17
Q

What should be considered if the bacteria is gram negative?

A

Serology

18
Q

When is staph epidermidis a cause for concern?

A

In patients with a prosthetic valve, can just be a contaminant in patients with a native valve

19
Q

What is the treatment for drugs users with endocarditis?

A

IV Flucoxacillin

20
Q

How will acute endocarditis present?

A

sepsis or cardiac failure (usually due to staph aureus)

21
Q

How will sub-acute endocarditis present?

A 
fever/SOB/weight loss 
murmur 
clubbing 
splinter haemorrhages 
splenomegaly 
janeway lesions/osler nodes
22
Q

Describe viridans group strep

A

appears green on culture & is alpha haemolytic

23
Q

In a patient with suspected endocarditis what investigations should be done?

A

Blood cultures, serology, ECHO

24
Q

Endocarditis due to a prosthetic heart valve is usually due to what bacteria?

A

Staph aureus/epidermidis

25
Q

What is the treatment for endocarditis due to a prosthetic valve?

A
  • vancomycin
  • gentamicin
  • rifampicin
26
Q

What treatment is given in a patient with native heart valves?

A

Amoxicillin & gentamicin IV

27
Q

After results what treatment is given?

A

staph aureus - flucloxacilin
viridian’s strep - benzylpenicillin & gentamicin
enterococcus - amoxicillin/vancomysin & gentamicin
staph epidermidis - vancomycin & gentamicin & rifampicin

28
Q

What are the symptoms of myocarditis?

A

fever, chest pain, SOB, palpitations

29
Q

What are the signs of myocarditis?

A

arrhythmias, cardiac failure

30
Q

What is the main cause of myocarditis and how is it diagnosed?

A

Enteroviruses

PCR by throat/stool sample

31
Q

Describe pericarditis

A

Often occurs with myocarditis and the main feature is chest pain. Usually viral

Cardiovascular (19 decks)

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