infective_endocarditis_flashcards
What is the definition of Infective Endocarditis (IE)?
Infective Endocarditis is an infection of the endocardial surface of the heart, often involving the heart valves, caused by bacterial or fungal pathogens.
What is the primary pathophysiological mechanism of IE?
IE typically follows endothelial damage, which promotes bacterial or fungal adhesion to heart structures, leading to vegetation formation composed of platelets, fibrin, and microorganisms.
What is the epidemiology of Infective Endocarditis?
The incidence of IE has been increasing, especially among older adults, IV drug users, and patients with cardiac devices. It is more common in males.
What are the common symptoms of IE?
Common symptoms of IE include fever, chills, night sweats, fatigue, weight loss, and symptoms of heart failure or embolic events.
What are the main risk factors for IE?
Major risk factors for IE include prosthetic heart valves, congenital heart disease, intravenous drug use, and recent invasive procedures.
What are characteristic findings on examination in IE?
Characteristic findings in IE include new or changing heart murmurs, Janeway lesions, Osler nodes, Roth spots, splinter hemorrhages, and splenomegaly.
What bedside investigations are used in IE?
ECG is used in IE to detect new conduction abnormalities or ischemic changes related to endocardial infection.
What blood tests are important in the assessment of IE?
Blood cultures are critical in IE for identifying the causative organism. Elevated CRP, ESR, and anemia may also be present.
What imaging is essential for diagnosing IE?
Transthoracic Echocardiography (TTE) is essential for visualizing vegetations, valve involvement, and assessing heart function.
When is Transesophageal Echocardiography (TEE) used in IE?
TEE is used in IE when TTE is inconclusive, particularly for detecting small vegetations, abscesses, or evaluating prosthetic valves.
What special tests are used to detect embolic lesions in IE?
CT or MRI may be used in IE to detect embolic lesions in the brain, kidneys, spleen, or lungs.
What lifestyle modifications are recommended for IE?
Lifestyle modifications include good dental hygiene and limiting invasive procedures in high-risk patients to reduce infection risk.
What are the medical management options for IE?
Empirical broad-spectrum antibiotics are used initially, adjusted based on culture results; typical therapy duration is 4-6 weeks.
When is surgery indicated in the treatment of IE?
Surgery is indicated in IE for severe valve damage, uncontrolled infection, large vegetations at risk of embolism, or prosthetic valve infection.
What are the risks associated with prolonged antibiotic therapy in IE?
Prolonged antibiotic therapy can increase risks of nephrotoxicity, allergic reactions, and antibiotic resistance.
