Endocarditis Flashcards
Endocarditis Mnemonic
FROM JANE
Fever Roth Spots (Retinal) Osler nodes (painful) Murmur (Holosystolic or Diastolic) Janeway Lesions (non-painful macules hands/feet) Anemia Nail Hemorrhages (splinter hemorrharges) Emboli (lungs or brain)
Endocarditis is an infection of the
endocardium
commonly infects the mitral valve
Endocarditis risk factors include:
IVDU
Prosthetic heart valves
Valvular disease
4
GI malignancy
Immunosuppressant agents
Rheumatic heart disease
IV Caths
MCC of Endocarditis in IVDU
Staph A.
MCC of Endocarditis following dental procedures
Streptococci Viridians
native valves
MCC of Endocarditis in Prosthetic valves
Staphylococcus Coagulase NEG
(S. Epidermidis & S. Saprophyticus)
POOR Prognosis
Which valve is most commonly affected in IVDU with Endocarditis
Tricuspid > Mitral> Aortic Regurgitation
Endocarditis complications (3)
Stroke (FND)
HF
Glomerulonephritis (hematuria/anuria)
Endocarditis ppx (PO-Amoxicillin) indicated if (2)
past hx
cardiac defects
high risk procedures (dental, GI or Lung surgery)
Tx for Endocarditis
IV Vanc + Cefepime/Ceftriaxone (native)
add Gentamicin + Rifampin (if prosthetic)
obtain Bcx (ideally before Abx)
Acute bacterial endocarditis
Rapid, fulminant progression (days to weeks)
Attacks Healthy native valves
MCC
S. aureus
associated with large vegetations that can destroy the valves
Subacute bacterial endocarditis Insidious onset Slow progression (weeks to months) Attacks Native valves with prior injury or congenital defects MCC
Viridans streptococci
Right sided endocarditis
MCC S. aureus (MSSA > MRSA)
Attacks tricuspid
Often associated with (2):
IV drug use
indwelling venous catheters
What’s one PE finding that screams Endocarditis?
New Valvular Regurgitation
(or worsening murmur)
Holosystolic/Diastolic
