path 2

Question 1

endocarditis findings

Answer 1

1. Valve Leaflets and Cusps: fibrosis, fusion, calcification
2. Chordae Tendinea: fibrosis, fusion, and shortening

Question 2

Rheumatic heart disease: chordae tendinae

Answer 2

1. thickened/fibrotic
2. fusion
3. shortened

Question 3

timeline of rheumatic heart disease

Answer 3

1. initial group A step infection (Strep throat)
(2-6 weeks)
2. acute rheumatic fever
(years or decades)
3. rheumatic heart diease

Question 4

Vegetations

Answer 4

1. Sterile / Marantic / Non-Bacterial Thrombotic Endocarditis
2. thrombus (clot) formation on valve
3. sterile = nor organism

Question 5

Vegetations Etiology

Answer 5

1. Damaged Valve:
   a. Rheumatic heart disease
   b. Lupus: “Libman-Sachs Endocarditis”
2. Normal Valve:
3. Hypercoagulable state

Question 6

Vegetations complicationsq

Answer 6

1. • Embolism
2. Valve function deficits – especially when large
3. Potential to become infected: fertile culture medium

Question 7

causes of infective endocarditis

Answer 7

1. Bacteria – most common: sources include skin/oral flora/GI tract
2. Strep. viridans – 50 - 60% of cases
3. Virulent organisms can attack diseased valves too
4. Fungal organisms – can occur but considerably less common than bacterial organisms

Question 8

endocarditis bacteremic episode:

Answer 8

1. allow organisms to be implanted on the valve / endocardial surfaces.
2. Mucosal injuries (anywhere in the GI system): e.g. Diverticulitis
3. Skin injuries
4. acute endocarditis
5. highly virulent
6. can infect normal and abnormal valves

Question 9

bacteremic episodes caused by

Answer 9

1. Dental procedures (and brushing one’s teeth too)
2. Surgical procedures
3. Venous access for interventional and catheterization purposes, indwelling access lines
4. Venous access for intravenous drug abuse passing through non- decontaminated skin

Question 10

complications of infectious endocarditis

Answer 10

1. “Septic Emboli” – to heart, various organs, skin (“Janeway lesions”)
2. Compromised valve function due to damage by bacteria and inflammatory response

Question 11

most common primary tumor in heart of teens and adults?

Answer 11

cardiac myxoma

in LV

Question 12

most common heart tumor in kids/infancy

Answer 12

rhabdomyoma