Cardiovascular: Infective endocarditis (brief) Flashcards
what is endocarditis?
infection of the endocardium
what are the orders of heart muscle from inside the heart to out?
endocardium myocardium visceral pericardium pericardial cavity parietal pericardium fibrous layer
how does endocarditis occur?
bacteria enter your bloodstream, travel to your heart, and attach to abnormal heart valves or damaged heart tissue
what are the most common bacteria to cause endocarditis?
staph aureus (most commonly)
others include: Viridans streptococci, Staphylococcus epidermidis (prosthetics), Enterococcus faecalis, Streptococcus bovis, Coxiella burnetti (animals).
what are risk factors for endocarditis?
- artificial heart valves
- congenital heart defects
- personal history of endocarditis
- damaged heart valves
- IV. drug use
- hypertrophic cardiomyopathy
what are some clinical features of endocarditis?
- flu-like symptoms
- new or changed murmur
- fatigue
- aching joints/muscles
- night sweats
- SOB
- chest pain when you breathe
which conditions present in a similar way to endocarditis?
SLE. Cardiac tumours. Lyme disease. Antiphospholipid syndrome. Polymyalgia rheumatica. Reactive arthritis.
what investigations would you conduct to confirm a diagnosis of endocarditis?
- blood cultures
- FBC
- echo/transoesophageal echo
- ECG
- CXR
what is the treatment for infective endocarditis?
IV antibiotics - Once cultures have been collected, broad-spectrum antibiotic therapy should be initiated until sensitivities are known.
Surgery sometimes recommended to remove. infective tissue
which antibiotic may be prescribed to prevent endocarditis as a preoperative prophylaxis?
vancomycin
[in patients at high risk of developing bacterial endocarditis when undergoing major surgical procedures]
what signs may you find on examination with a patient with endocarditis?
Murmur / septic emboli / splinter haemorrhages / Janeway lesions / Osler’s nodes / Roth spots / clubbing / arthritis / fever / anaemia / splenomegaly
what is the prognosis of endocarditis?
good - 90% of patients recover with treatment.
