Cvs Flashcards
Differences b/w acute endocarditis and subacute endocarditis.
Pg 287
Pathogenesis of infective endocarditis
Underlying risk factors[underlying cardiac defect, congenital valvular disease,iv catheter, prosthetic value]
Endothelial injury → deposition of fibrin and platelets → thrombus→ serves as site for bacterial attachment → colonization → endothelial surface gets covered with protective layer of fibrin and platelets → favourable for further multiplication→vegetation → metastasize to different organs
Vegetation
Web of platelets, fibrin, inflammatory cells and entrapped organisms
Agents of infective endocarditis
Oral cavity → viridian’s streptococci
Skin→ staphylococci
> respiratory →hacek group
Gastrointestinal → J streptococci1 enterococci
Clinical manifestations of IE
CARDIAC → new or worsened murmur
EXTRA CARDIAC→ fever, chills, sweat, anorexia, weight loss, clubbing, petechia, arthralgia, splenomegaly, painful ostersnodes, sublingual hemosehages, janeway lesions(painless)
Modified dukes criteria for IE
Major criteria →1 positive blood culture 2. Evidence of endocardia involvement
Minor criteria→ 1 predisposition 2. Fever 3. Vascular phenomena 4. Immunologic phenomena 5. Microbiologic evidence
Definitive endocarditis → 2 major criteria, 5 minor criteria, one major and 3 minor
Acute rheumatic fever, causative agents
Group A streptococcus→ streptococcus pyogenes
Difference b/w acute rheumatic fever and rheumatic heart disease
Arf is a multisystem disease that occurs in people previously having sore throat as a result of autoimmune reactions all manifestations resolve except valvular damage called rheumatic heart disease
ARF common in age group
Children of age: 5 to 14 years
RHD common in females
Auto immune theory of acute, rheumatic few
Molecular mimicry → ab targeted against streptococcal antigens cross react with human tissue c heart and joint) ag these cross reactive ab bind to valvular endothelia and cause damage to heart - valves
Clinical manifestations of ARF
Migrating poly arthritis
pancarditis
subcutaneous nodules
chorea
erythema marination
Diagnosis of arf→ criteria?
Modified jones
Jones criteria
Major → carditis, poly arthralgia, chorea, subcutaneous nodules, arthritis (poly), erythema marginatum
Minor → monoarthralgia 1hyperpyresia I prolonged pr interval, ESR CRPraised
Prevention of ARF
Primary prevention → complete treatment of group a streptococcal sore throat with in nine days with penicillin
Secondary prevention→ benzathine penicillin G I’m
page 294
Scoring system used to asses the severity of infection and extent q organ Filene
Sofa score and quick sofa score criterial bedside)
