Infective Endocarditis

Question 1

occurs when microorganisms invade vulvular endothelium and cause proliferative or erosive lesions

Answer 1

infective endocarditis

Question 2

lesions in which platelets, fibrin, microorganisms and inflammatory cells are found

Answer 2

vegetative

Question 3

T/F: in cases of infective endocarditis bacteria can be internalized by the endothelium and other cells

Answer 3

TRUE, ability to hide from immune system

Question 4

T/F: you tend to see infective endocarditis in cats more than dogs

Answer 4

FALSE, dogs uncommon and cats rare

Question 5

what two valves are most commonly affected by infective endocarditis?

Answer 5

mitral and aortic

Question 6

T/F: mitral valve regurg is a dystolic dysfunction while aortic valve regurg is a systolic dysfunction

Answer 6

FALSE, opposite

Question 7

what is required for the development of infectious endocarditis?

Answer 7

bacteremia (can be from anything)

Question 8

what congenital heart dz can be a risk factor for infectious endocarditis?

Answer 8

subaortic stenosis

Question 9

what clinical syndromes might manifest in a patient with infectious endocarditis?

Answer 9

immune-mediated dz (polyarthritis and glomerulonephritis MC), CHF and arrhythmias, thromboembolic dz

Question 10

what is the most common signalment of patients with infectious endocarditis?

Answer 10

middle-age to older, medium-LBD

-GSD, golden retrievers, labs

Question 11

what is the most common presenting complaint for infectious endocarditis?

Answer 11

LAMENESS

Question 12

T/F: the majority of dogs with infectious endocarditis have a heart murmur and arrhythmia

Answer 12

TRUE (mitral: L-apical systolic, aortic: L-basilar diastolic +/- bounding femoral pulses)

Question 13

what bacteria would you not commonly see a fever with if the patient has concurrent IE?

Answer 13

bartonella (hides from immune system!)

Question 14

what two important proteins might be lost in urine in a patient with IE and concurrent glomerular dz?

Answer 14

albumin and antithrombin III

Question 15

what might you commonly see on thoracic radiographs of a patient with IE?

Answer 15

L-CHF

Question 16

what would you see on an echo in a patient with IE that would aid in your diagnosis?

Answer 16

large vegetative lesions

Question 17

what are the most common causative agents of infectious endocarditis?

Answer 17

staph, strep, e. coli, pseudomonas, and bartonella

Question 18

what is the mainstay of therapy for patients with IE?

Answer 18

long-term bactericidal antibiotics

-beta lactam, +/- aminoglycoside (no CHF), enrofloxacin

Question 19

what valve affected with IE would give you a better prognosis?

Answer 19

mitral valve (>1 year), aortic=grave (days)

Question 20

when would you consider giving a patient preventative antibiotics (i.e. beta-lactam, cephalosporin) due to concern of developing IE?

Answer 20

congenital heart dz (SAS) and if immunosuppressed

Question 21

myocardial inflammation in the absence of ischemia > myocyte damage and cardiac dysfunction

Answer 21

myocarditis

Question 22

why can diagnosing myocarditis be a challenge?

Answer 22

usually presents with vague signs

Question 23

what arrhythmia is commonly seen in patients with myocarditis?

Answer 23

VPCs

Question 24

what might you commonly see in patients with acute myocarditis that can aide in your diagnosis?

Answer 24

increase in cardiac troponin I (cTnI) serum level

Question 25

what is the most common cause of myocarditis in dogs in Texas and the southern US?

Answer 25

trypanosoma cruzi (chagas dz)