Infective Endocarditis Flashcards
Define Infective Endocarditis
infection of the endothelium of the heart valves
Biggest cause of the rise of endocarditis in hospital
Staphylococcus Aureus
Endocarditis Risk Factors
Heart valve abnormality
Prosthetic Heart Valve
IV Drug User
Heart valve abnormality examples
calcification/sclerosois (elderly)
congenital heart disease
post rheumatic fever
Pathogenesis of Infective Endocarditis
Heart valve damage
Turbulent blood flow to valve endothelium
Platelets/fibrin deposited
Bacteria
Organism settle in fibrin/platelet thrombi –> MICROBIAL VEGITATION
Side of the heart most commonly affected by endocarditis
Left
Endocarditis causative organisms
Staphylococcus Aureus
Viridians Streptococci
Enterococcus SP
Staphylococcus Epidermidis
Native Endocarditis presenting symptoms
sepsis and heart failure
Native endocarditis investigations
3 x blood culture
Echo
Prosthetic Valve Endocarditis Early Presentation
(
Prosthetic Valve Endocarditis Late Presentation
(years)
co-incidental bacteria
IV Drug User Endocarditis
RIGHT sided –> tricuspid valve
STAPHYLOCOCCUS AUREUS
Present with staphylococcus aureus pneumonia
Endocarditis Treatment (empirical)
HIGH DOSE FREQUENT ANTIBIOTICS
Native Endocarditis Treatment
AMOXICILLIN
GENTAMICIN IV
Prosthetic Endocarditis Treatment
VANCOMYCIN
GENTAMICIN IV
RIFAMPICIN PO
(valve replacement)
Drug User Endocarditis Treatment
Flucloxacillin IV
Staphylococcus Aureus
FLUCLOXACILLIN IV
MRSA
VANCOMUCYCIN IV
RIFAMPICIN PO
Viridian’s Streptococci
BENZYLPENICILLIN
GENTAMICIN IV
Enterococcus SP
AMOXICILLIN
VANCOMYCIN
GENTTAMICIN IV
Staphylococcus Epidermidis
VANCOMYCIN
GENTAMICIN IV
RIFAMPICIN PO
Endocarditis Monitoring
IV antibiotics for 4-6 weeks
Cardiac function, temperature, serum C-reactive protein (CPP)
Myocarditis
Inflammation of the cardiac muscle
Myocarditis buzz words
Young people
fever, chest pain, SOB, palpitations
arrhythmia, cardiac function
Myocarditis main cause
ENTEROVIRUSES (throat swab + stool)
Coxsackie A&B, echovirus
Pericarditis
Inflammation of the pericardium
Pericarditis buzz words
MYOCARDITIS
Chest Pain
Pericarditis main cause
VIRAL AETIOLOGY
but can also be caused by bacteria after cardiothoracic surgery
NAG
for Native endocarditis the treatment is Amoxicillin and Gentamicin
