Infective Endocarditis Flashcards
occurs when microorganisms invade vulvular endothelium and cause proliferative or erosive lesions
infective endocarditis
lesions in which platelets, fibrin, microorganisms and inflammatory cells are found
vegetative
T/F: in cases of infective endocarditis bacteria can be internalized by the endothelium and other cells
TRUE, ability to hide from immune system
T/F: you tend to see infective endocarditis in cats more than dogs
FALSE, dogs uncommon and cats rare
what two valves are most commonly affected by infective endocarditis?
mitral and aortic
T/F: mitral valve regurg is a dystolic dysfunction while aortic valve regurg is a systolic dysfunction
FALSE, opposite
what is required for the development of infectious endocarditis?
bacteremia (can be from anything)
what congenital heart dz can be a risk factor for infectious endocarditis?
subaortic stenosis
what clinical syndromes might manifest in a patient with infectious endocarditis?
immune-mediated dz (polyarthritis and glomerulonephritis MC), CHF and arrhythmias, thromboembolic dz
what is the most common signalment of patients with infectious endocarditis?
middle-age to older, medium-LBD
-GSD, golden retrievers, labs
what is the most common presenting complaint for infectious endocarditis?
LAMENESS
T/F: the majority of dogs with infectious endocarditis have a heart murmur and arrhythmia
TRUE (mitral: L-apical systolic, aortic: L-basilar diastolic +/- bounding femoral pulses)
what bacteria would you not commonly see a fever with if the patient has concurrent IE?
bartonella (hides from immune system!)
what two important proteins might be lost in urine in a patient with IE and concurrent glomerular dz?
albumin and antithrombin III
what might you commonly see on thoracic radiographs of a patient with IE?
L-CHF
what would you see on an echo in a patient with IE that would aid in your diagnosis?
large vegetative lesions
what are the most common causative agents of infectious endocarditis?
staph, strep, e. coli, pseudomonas, and bartonella
what is the mainstay of therapy for patients with IE?
long-term bactericidal antibiotics
-beta lactam, +/- aminoglycoside (no CHF), enrofloxacin
what valve affected with IE would give you a better prognosis?
mitral valve (>1 year), aortic=grave (days)
when would you consider giving a patient preventative antibiotics (i.e. beta-lactam, cephalosporin) due to concern of developing IE?
congenital heart dz (SAS) and if immunosuppressed
myocardial inflammation in the absence of ischemia > myocyte damage and cardiac dysfunction
myocarditis
why can diagnosing myocarditis be a challenge?
usually presents with vague signs
what arrhythmia is commonly seen in patients with myocarditis?
VPCs
what might you commonly see in patients with acute myocarditis that can aide in your diagnosis?
increase in cardiac troponin I (cTnI) serum level
what is the most common cause of myocarditis in dogs in Texas and the southern US?
trypanosoma cruzi (chagas dz)
