Endocarditis Flashcards
Where is the inflammation in endocarditis?
Inflammation of the endothelial or inner layer of the heart (this endothelium is continuous with the heart valves)
What are the risk factors for developing infective endocarditis?
IV drug abuse Male > female Prosthetic valves Dental work Congenital heart diseases Hypertrophic cardiomyopathy
Why does dental work increase risk of infective endocarditis?
The causal bacteria live in the mouth:
Poor dental hygiene followed by dental work which may cut the gum, exposing the blood vessels to the pathogen
What is vegetation?
Growth and colonisation of bacteria in the endocardium
What is the risk of vegetation?
Forms thrombus - can throw off emboli
Calcification - valve may become stenosed
What is the risk of thrombus forming from vegetation in the tricuspid valve?
PE - tricuspid valve related to pulmonary circulation
What is a potential complication of infective endocarditis if the valves are destroyed?
Heart failure
What complications may arise from vegetation from valves in the left side of the heart?
Embolus in brain, kidney, spleen etc
What signs may be seen in the hands that indicate endocarditis?
Oslers nodes
Splinter haemorrhages
What causes Osler’s nodes and splinter haemorrhages?
Emboli that have travelled and become lodged in the peripheral circulation
What cardiac signs may be present O/E that indicate valve involvement in endocarditis?
New murmur
Reduced cardiac output
Arrythmias (mainly AV blocks)
What are Oslers nodes?
Painful, red, raised lesions found on the hands and feet
What is a Janeways lesion?
Flat, painless, red/blueish nodes found on palms and soles
What sign may be seen in the eyes in infective endocarditis?
Retinal haemorrhage
What is the clinical presentation of endocarditis?
Fever
Murmur
Janeway lesions, splinter haemorrhages, Oslers nodes
