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Infective Endo is defined as a localized infection anywhere on the _________.
Endocardium.
IE results from _______ or _______ infection of the endocardial surface of the heart, including valves.
bacterial or fungal
________ is associated with significant morbidity and mortality (20-25%) and if left untreated 100% mortality rate.
IE
What are clinial ways to identify IE?
Clinical course (acute or subacute)
Host substrate (native valve)
Specific infecting Microorganism
Pathogenesis of IE. (what needs to happen for IE to occur)
1. Endocardial surface injury 2. Platelet-fibrin-thrombus formation at site of injury
3. Bacterial entry in circulation 4. bacterial adherence to wall
What are the Risk Factors for IE
*Prosthetic Valve *recent Hx of invasive procedure (25%) *IV abuse
*structural or congenital heart disease
what are some clinical manifestation of IE?
unexplained fevers, night sweats, fatigue, weakness, systemic illness, signs of HF
How do we diagnose IE. explain steps
Dukes Criteria: Clinical, Labs and echo findings
what are the goals of echo while diagnosing IE.
*presence, location and size of vegetation. *valve dysfunction. *valve dysfun impact on LV size and systolic func. *other comp (PE...)
True/false: echo provides anticipated timing of surgical intervention
True
what would echo findings represent for valvular vegetation
abnormal echogenic, irregular mass (attached to valve), site of attachment, more chaortic valve motion than normal
what are some IE complications.
*embolization (left: stroke, ischemia, renal failure, right: PE or pneumonia)
* Leaflet perforation, flail * acute regurge *tamponade *HF
Complications develop in approx ____% for patients being treated for IE.
40%
Classification of high or low risk include:
age, clinical status, type, HF, IV drug us Hx
____ valve has 3 times more involvement in an emoblic event.
Mitral valve
Echo Parameter consistent with risk vegetation size
a) <7mm = _____% complication
b) >11mm = _____% complication
a) <10%
b) >50%
