infective endocarditis and rheumatic heart disease

Question 1

What is the presentation of infective endocarditis

Answer 1

• fever
• Heart murmur
• Weight loss
• Roth spots - white centred retinal haemorrhage
• Peripheral infarcts
• Splenic infarcts
• Septic pulmonary embolism
• Embolic stroke
• Splinter haemmorhage

Question 2

What is used to diagnose endocarditis

Answer 2

ECHO

Question 3

What is the usual history of Rheumatic heart diseaee

Answer 3

1. Group A strep (strep pyogenes) infection
2. Carditis plus painful joints
3. Rheumatic heart disease after years of rheumatic fever

Question 4

Which valve is usually affected in rheumatic heart disease

Answer 4

The left sided valves - commonly mitral stenosis

Question 5

What is the treatment of rheumatic heart disease

Answer 5

• Diuretics
• ACEi or ARBs
• Beta blockers
• Digoxin
• Anticoagulation (warfarin)
• Ballon mitral valvuloplasty