Endocarditis Flashcards
1
Q
What is it?
A
infection of heart valves
2
Q
important to check in IVDU
A
feet
as veins become unusable due to drug use so they start injecting their feet
3
Q
risk factors
A
artificial heart valves previous infectious endocarditis intracardiac devices chronic rheumatic heart disease age-related degeneration of valves intravenous drug user immunosuppression recent dental procedure
4
Q
investigations
A
blood culture FBC U&Es VBG CXR ECG Urine dipstick 3 blood cultures from 3 different sites Transthoracic/transoesophageal echo
5
Q
TTE vs TOE
A
transthoracic not able to exclude bacterial endocarditis so often TOE is needed
6
Q
blood results
A
raised creatinine
raised CRP
raised WCC and neutrophils
raised lactate
7
Q
clinical features
A
systolic murmur sepsis raised inflammatory markers raised RR prolonged capillary refill time low BP reduced GCS pyrexia tachycardia
8
Q
what are the types of endocarditis?
A
acute and subacute/chronic
9
Q
acute presentation
A
develops over days-weeks fever tachycardia fatigue progressive damage to cardiac structures
10
Q
subacute presentation
A
typically develops over course of weeks-months vague constitutional symptoms low-grade fever weight loss fatigue night sweats appetite loss
11
Q
pathophysiology
A
turbulent blood flow endothelial damage to valvular surfaces platelets and fibrin adhere prothrombotic platform bacteraemia colonisation of thrombus more fibrin deposition platelet aggregation vegetation
12
Q
bacterial causes
A
streptococcus viridans staphylococcus aureus enterococci coagulase-negative staphylococci haemophilus parainfluenzae
13
Q
bacterial causes in non-IVDU
A
streptococci viridans
enterococci
staphylococci
14
Q
bacterial causes in IVDU
A
right sided valvular involvement staphylococcus aureus streptococci gram-negative bacilli polymicrobial infections fungal cause less common
15
Q
signs on examination
A
splinter haemorrhage - nails
osler nodes on hand
janeway lesions on hand
roth’s spots on fundoscopy of eye
