Endocarditis Flashcards
Valves affected in IE in order of likelihood?
Mitral > aortic > tricuspid > pulmonary
Commonest organisms implicated? (2)
Strep viridans (35-50%) Staph aureus (20%)
Vasculitic manifestations of IE?
Microscopic haematuria
Splinter haemorrhages
Osler’s nodes
Janeway lesions
Osler’s nodes
Painful lesions on finger pulps
Janeway lesions
Non erythematous macules on palms
High-risk patients for IE? (5)
Acquired valve disease Valve replacement Structural heart disease Hypertrophic cardiomyopathy Iv drug abuse
Antibiotic prophylaxis for IE
Not currently recommended
Peak incidence of rheumatic fever?
5-15
Pathophysiology of rheumatic fever?
Infection with group A B-haemolytic streptococcus (strep pyogenes); hypersensitivity reaction caused by cross-linking antibodies
Manifestations of rheumatic fever? (4)
Large-joint flitting/migratory arthritis Carditis (endo-, myo-, peri-) Chorea Erythema marginatum Subcutaneous nodules
Criteria used to diagnosis rheumatic fever?
Revised Jones criteria
Valve most commonly affected long-term with rheumatic fever?
Mitral valve
Secondary prophylaxis for rheumatic fever?
PenV or sulfadiazine
for at least five years or until age 21, whichever is longer
10 years for RF with carditis but no valvular disease
Presentation of myocarditis
Often similar to MI with chest pain
Management of myocarditis
Supportive; admit for monitoring
