Murmurs Flashcards
Aortic stenosis (2)
- Early systolic
- Carotids
Aortic regurgiation (3)
- Sitting forward
- Full expiration
- Early diastolic
Mitral regurgiation (2)
- Axilla
- Pan systolic
Mitral stenosis (2)
- Mid diastolic
- Roll left hand side with bell
Infective endocarditis main symptom?
FEVER
How does infective endocarditus present chronically/subacutely?
Low grade fever and non specific symptoms
What are the acute symptoms of infective endocarditus? (3)
1) Constitutional symptoms: fever/malaise
2) Cardiac manifestation: new/changed murmur or arrythmia
3) Organ effect: haematuria (glomerulonephritis)
What are the acute signs on examination of infective endocarditius? (6)
- Osler’s nodes
- Janeway lesions
- Petechiae
- Clubbing
- Splinter hemorrhages
- Roth spots: red spots with white centres via fundoscopy
Sources of infective endocarditus
- IV drug use
- Prolonged indwelling vascular catheter
- Dental disease
- Within 60 days of valve surgery
- Diabetes (soft tissue infections)
- Underlying GI disease
- Immunosurpression
How can we tell if infective endocarditis is caused by the prosthetic surgery or was community accquired?
Within 60 days of surgery = surgery
What organism causes infective endocarditus within 60 days (surgery)? (2)
- Staph epidermidis
- Staph aureus
What organism causes infective endocarditus after 60 days of valve surgery (community accquired)? (2)
- Strep viridans
- Staph aureus
What organism causes infective endocarditus due to dental disease/procedures?
Strep mutans
What organism causes infective endocarditus due to IV drug use/vascular catheter?
Staph aureus
What are the next investigations of suspected infective endocarditis? (5)
- Do a blood culture for causative organism
- FBC
- Increased urea and creatinine
- Increased ALP
- Urine dip (protein and blood)
