Diagnosis

Question 1

What is the clinical criteria for the diagnosis of infective endocarditis?

Answer 1

Either of the following:

• 2 major criteria
• 1 major and 3 minor
• 5 minor criteria

Question 2

What is the major criteria for infective endocarditis?

Answer 2

Positive blood culture
- typical micro-organism consistent in 2 separate cultures OR
- persistently + blood cultures e.g. 3 >12hrs apart OR
- single positive blood culture for coxiella burnetii
Endocardium involved:
- Positive echocardiogram for IE (vegetation, abscess, pseudoaneurysm, dehiscence of prosthetic valve) OR
- abnormal activity around prosthetic valve on PET/CT or SPECT/CT OR
- paravalvular lesions on cardiac CT

Question 3

What is the minor criteria for infective endocarditis?

Answer 3

• Predisposition (cardiac lesion, IV drug abuse)
• Fever > 38 degrees
• Vascular phenomena (emboli, Janeway’s lesions etc)
• Immunological phenomena (glomerulonephritis, Osler’s nodes etc)
• Positive blood culture that does not meet major criteria

Question 4

What is the New York classification of HF?

Answer 4

1. Heart disease present but no undue dyspnoea from ordinary activity
2. Comfortable at rest, dyspnoea during ordinary activities
3. Less than ordinary activity causes dyspnoea, which is limiting
4. Dyspnoea present at rest, all activity causes discomfort