Endocarditis Flashcards
What is endocarditis
it is an infection of the endocardium - usually on the valves
How does the infection occur
microbial colonization of the thrombi on endocardial surface abnormalities
What organisms are implicated
many but mainly oral streptococci
Describe the pathophysiology of infective endocarditis
- surface abnormality present
- results in haemodynamic changes
- results in turbulence
- platelet/fibrin deposition (thrombus)
- vegetation
- microbial attachment and multiplication
- enlargement of vegetation
What are the common physical findings in infective endocarditis
fever
heart murmur
embolic phenomena
skin manifestation
What is the effect of infective endocarditis
prolonged antibiotic treatment
cardiac valve damage
significant risk fo death from disease or complications
What is required from patients at risk for endocarditis
consequence of ABP must be discussed
consequence of NO ABP must be discussed
for cases who are ‘high risk’ undergoing invasive dental procedures
What procedures are likely to produce a significant bacteraemia
those involving dento-ginigval manipulation
What treatments are a risk
extraction
periodontal therapy
implants
restorations if the gingival margin is involved or if a matrix is used
Who is the decision on prophylaxis made by
px and physician
communicated to dentist in writing
What should be told for endocarditis px regarding prevention
bacteraemia is normally produced - need to reduce this through excellent oral hygiene
What is the advice for reducing risk
attending for oral care
rapid management infection
maximal oral hygiene and prevention
avoiding risk activity - piercings
What is the drug regime for endocarditis
amoxycillin 3g oral 1 hour before procedure under supervision
if allergic then clindamycin 1.5g
