Infective Endocarditis Flashcards
What is it?
Infection of the endocardial layer of the heart (the inner layer)
What allows it to happen?
All cases have a sterile fibrin-platelet vegetation as the prerequisite for infection that allows the bacteria to stick
What are acute causes?
A thrombus is produced by invading organisms or from trauma e.g cardiac catheter
What are the subacute causes?
Sufficient innoculum of bacteria to invade the thrombus already present
Which valve is most commonly affected?
THE MITRAL VALVE, and then the aortic valve
What is the most common causative organism?
Staphylococcus Aureus, then Streptococcus Viridans
Is it common?
Not really, 2 per 100,000 people
Who does it affect?
40% occurs in over 60’s, and most commonly affects males
Risk factors (7)
Valvular disease (stenosis or regurgitation), Valve replacement, structural congenital heart disease, previous infective endocarditis, hypertrophic cardiomyopathy, IVDU, dental work
Symptoms (6)
Fever, rigors, night sweats, malaise, weight loss, abdominal pain (from splenic infarcts)
Signs (8)
Anaemia, splenomegaly, clubbing, splinter haemorrhages, roth spots, janeway lesions, oslers nodes, heart murmur
When is a high index of suspicion required?
Fever and new onset murmur
Differentials (5)
SLE, Cardiac tumour, malignancy, antiphospholipid syndrome, P.E
What bloods would you do? (9)
FBC, U&E, LFT, CRP, Blood Cultures, Lactate, BNP, Cardiac markers, TFT
Other investigations(7)
Chest xray, ECG, ECHO, TOE, Urinalysis, MRI, CT
