Infective Endocarditis Flashcards
what is infective endocarditis?
infection of the endocardium, microbial colonisation of thrombi on endocardial surface abnormalities
what is the main oral bacterial involved?
streptococci
how does infective endocarditis happen?
bacteria entering from mouth intro circulation and settling on previously damaged areas of the heart tissue. colonisation occurs within the thrombus and bacteria multiply to cause damage and spread of infections leading to vegetations
what groups are at higher risk of infective endocarditis?
previous cardiac damage, highest risk in older age group, prosthetic valves
what are the physical findings of infective endocarditis?
fever, heart murmur, embolic phenomena, skin manifestations, splenomegaly, septic complications, mycotic aneurysm
what is the effect of infective endocarditis?
prolonged antibiotic treatment and cardiac valve damage, also death
what cardiac patients are not a risk?
coronary artery bypass grafting, angioplasty and stent, hypokinetic cardiac muscle, implanted pacemaker and implanted defibrillator
which dental procedures are a risk?
procedures involving manipulation of the dento-gingival junction and causing a bacteraemia
list high risk dental procedures?
extractions, periodontal therapy, gingival surgery, implants, restorations (matrix use)
what should the dentist do for at risk patients?
identify them, prevent oral disease and excellent oral hygiene
what are the NICE guidelines?
no indication for antibiotic prophylaxis and dental efforts are to be concentrated on reducing risk by reducing size and frequency of oral bacteramia
how does the Montgomery ruling influence prophylaxis?
consequences of ABP must be discussed, consequences of no ABP must be discussed
who is the precision on prophylaxis decided by?
patient and their physician
