Infective Endocarditis Flashcards
What is infective endocarditis?
An infection of the heart’s inner lining (endocardium), often involving the heart valves.
What causes turbulence in blood flow in infective endocarditis?
Abnormal heart valves or structural defects.
How do platelets and fibrin contribute to infective endocarditis?
They form small masses (vegetations) where bacteria can adhere and grow.
What is the role of circulating bacteria in infective endocarditis?
Bacteria in the bloodstream can attach to damaged heart valves, causing infection.
What is valve destruction in infective endocarditis?
Damage to heart valves due to infection, leading to dysfunction.
What is embolization in infective endocarditis?
Pieces of infected tissue (vegetations) break off and travel to other organs, causing blockages.
What are the immunologic responses in infective endocarditis?
Immune complex deposition, leading to symptoms like glomerulonephritis and skin lesions.
What are the general symptoms of infective endocarditis?
Fever, malaise, anorexia, and arthralgia.
What is toxemia in infective endocarditis?
Systemic symptoms caused by bacterial toxins, including fever and fatigue.
What is sub-conjunctival hemorrhage?
Bleeding under the conjunctiva, often seen in infective endocarditis.
What is splinter hemorrhage?
Linear bleeding under the nails, a sign of infective endocarditis.
What is a petechial rash?
Small red or purple spots on the skin caused by bleeding.
What are Janeway lesions?
Painless hemorrhagic lesions on the palms or soles.
What are Osler nodes?
Painful, raised nodules on the fingertips or toes.
What are Roth spots?
Retinal hemorrhages with a pale center, seen in infective endocarditis.
What are the cerebral complications of infective endocarditis?
Stroke, brain abscess, or mycotic aneurysms.
What are the symptoms of pulmonary embolism in infective endocarditis?
Cough, dyspnea, hemoptysis, and chest pain.
What is digital gangrene?
Tissue death in the fingers or toes due to blocked blood flow.
What are the renal complications of infective endocarditis?
Hematuria and renal infarction.
What are the Duke criteria for diagnosing infective endocarditis?
A set of major and minor criteria used to diagnose the condition.
What are the major Duke criteria?
Positive blood cultures and evidence of endocardial involvement on echocardiography.
What are the minor Duke criteria?
Fever, predisposing factors, vascular phenomena, and immunologic phenomena.
How many blood cultures are needed for diagnosis?
At least 2 positive cultures drawn >12 hours apart.
What is the role of echocardiography in diagnosis?
To detect vegetations, abscesses, or valve regurgitation.
What is the difference between trans-thoracic and trans-esophageal echocardiography?
Trans-esophageal echocardiography provides better visualization, especially for prosthetic valves.
What are predisposing factors for infective endocarditis?
Heart valve abnormalities, prosthetic valves, or recent dental procedures.
What are vascular embolic manifestations?
Stroke, retinal infarction, or splenic infarction.
What are immune complex deposition manifestations?
Glomerulonephritis, Roth spots, and Osler nodes.
What is the first step in treating infective endocarditis?
Starting antibiotic therapy based on blood culture results.
What antibiotics are used for staphylococcal endocarditis?
Methicillin or vancomycin, often combined with gentamicin.
What is the treatment for streptococcal endocarditis?
Penicillin G or ceftriaxone for 4 weeks.
What is the treatment for fungal endocarditis?
Amphotericin B.
When is surgery indicated for infective endocarditis?
For heart failure, large vegetations, or prosthetic valve involvement.
What is the role of bed rest in treatment?
To reduce strain on the heart until symptoms improve.
What dietary restrictions are recommended?
Salt and fluid restriction in heart failure.
What is septic embolism?
Infected material breaking off and traveling to other organs.
What is a mycotic aneurysm?
A weakened blood vessel wall caused by infection.
What is splenic infarction?
Blockage of blood flow to the spleen, causing tissue death.
What is glomerulonephritis?
Kidney inflammation due to immune complex deposition.
What is the mortality rate of infective endocarditis?
Approximately 20-30%, depending on complications.
What is antibiotic prophylaxis for infective endocarditis?
Antibiotics given before dental or surgical procedures to prevent infection.
Who should receive antibiotic prophylaxis?
Patients with prosthetic valves or congenital heart defects.
What antibiotics are used for prophylaxis?
Ampicillin or clindamycin for allergic patients.
What is the significance of blood cultures in infective endocarditis?
They identify the causative organism and guide antibiotic therapy.
What is the role of CT scans in infective endocarditis?
To detect brain emboli or abscesses.
What is the role of fundoscopy in infective endocarditis?
To identify Roth spots or retinal hemorrhages.
What is the role of chest radiography in infective endocarditis?
To detect pulmonary emboli or infiltrates.
What is the role of abdominal ultrasound in infective endocarditis?
To detect splenic or renal infarctions.
What is the recovery rate for infective endocarditis?
Approximately 80%.
What is the significance of large vegetations (>10 mm)?
Higher risk of embolization and need for surgery.
What is the role of Doppler ultrasound in infective endocarditis?
To detect vascular obstructions.
What is the role of blood picture in diagnosis?
To identify anemia, leukocytosis, and elevated ESR.
What is the significance of CRP in infective endocarditis?
It is a marker of inflammation and infection.
What is the role of trans-esophageal echocardiography in prosthetic valve endocarditis?
It provides better visualization of vegetations and abscesses.
What is the role of pulmonary scanning in infective endocarditis?
To detect pulmonary emboli.
What is the role of chest radiography in infective endocarditis?
To detect bilateral infiltrates, nodules, or pleural effusions.
