Endocarditis/Pericarditis/Myocarditis/Pericardial Effusion

Question 1

What is endocarditis?

Answer 1

A rare, serious infection of the lining of the heart and heart valves

Question 2

What are the 2 types of Endocarditis?

Answer 2

1. Infective Endocarditis (IE)

2. Non-infective (NBTE)

Question 3

What are the common symptoms of Infective Endocarditis?

Answer 3

Flu-like (fever, cough, fatigue)
Weight-loss
Pale skin (anaemia)
Muscle and Joint ache

Question 4

What are the clinical signs of infective endocarditis?

Answer 4

Heart Murmur
Splinter haemorrhages
Janeway lesions
Osler nodes
Roth spots
Splenomegaly

Question 5

What tests would you do on someone suspected of Infective Endocarditis?

Answer 5

Blood Culture
Echocardiogram (look for valvular vegetations)
Rheumatoid factor (+ve in IE)

Question 6

What system is used to establish a diagnosis of Infective Endocarditis?

Answer 6

Duke’s Criteria

Question 7

What are the common causative organisms for Infective Endocarditis?

Answer 7

Bacterial:
Staph aureus
Strep viridans
Enterococci

Fungi:
Candida albicans

Question 8

What are the risk factors for Infective Endocarditis?

Answer 8

DM, IVDU, HIV, Chronic Liver disease
Artificial valves
Congenital cardiac conditions
Chronic Rheumatic heart disease
Poor dental hygiene / recent dental operation

Question 9

How do you treat infective endocarditis?

Answer 9

In acute: IV Vancomycin and Ceftriaxone

Question 10

What are the risk factors for non-infective endocarditis (NBTE) ?

Answer 10

Previous rheumatic fever
Hypercoagulable states (sepsis, pregnancy)
Malignant cancers
SLE
Trauma