40 Endocarditis

Types and Causes

  • different microbiology for acute and subacute

  • staph epidermis: coagulase negative
  • binds to normal valve, no damage needed
  • express tissue factor, coagulation cascade

  • dextran adheres to fibrin that only appears on damaged endothelium
  • MVP risk

Symptoms

  • new heart murmur classic indication. Aortic regurgitation from valvular damage
  • small red spots on skin

  • a piece can break off and travel
  • splenic infarct: arterial thrombosis. Rare, also seen in lupus

  • immune response result in small complex deposition

  • Jane is nice person, not painful

  • abscess: bacteria developed pocket, usually at root of valve, lies right near AV node
  • new prolonged PR

Diagnosis

  • echodensity
  • bacterial growth on valve

Treatment

Others

  • usually because poor microbiology technique

  • lupus with new murmur
  • mucinous adenocarcinoma

  • enterococcus: women after OB, man after prostatic surgery