*embolization (left: stroke, ischemia, renal failure, right: PE or pneumonia)
* Leaflet perforation, flail * acute regurge *tamponade *HF
____ valve has 3 times more involvement in an emoblic event.
Mitral valve
these two imaging modalities show promise for the evaluation for IE
MRI and CT
IE results from _______ or _______ infection of the endocardial surface of the heart, including valves.
bacterial or fungal
Echo Parameter consistent with risk vegetation size
a) <7mm = _____% complication
b) >11mm = _____% complication
a) <10%
b) >50%
True/false: echo provides anticipated timing of surgical intervention
True
Classification of high or low risk include:
age, clinical status, type, HF, IV drug us Hx
what are some clinical manifestation of IE?
unexplained fevers, night sweats, fatigue, weakness, systemic illness, signs of HF
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 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...)
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
these two imaging modalities show promise for the evaluation for IE
MRI and CT
Infective Endo is defined as a localized infection anywhere on the _________.
Endocardium.
what is the treatment for IE and for how long and prevention.
Vancomyocin or ampicillin for 4-6weeks of high dose IV antibiotic therapy.
after complete therapy, pt should be educated on dental hygiene, prophylaxis need.
What are clinial ways to identify IE?
Clinical course (acute or subacute)
Host substrate (native valve)
Specific infecting Microorganism
________ is associated with significant morbidity and mortality (20-25%) and if left untreated 100% mortality rate.
IE
Complications develop in approx ____% for patients being treated for IE.
40%
How do we diagnose IE. explain steps
Dukes Criteria: Clinical, Labs and echo findings
What are the Risk Factors for IE
*Prosthetic Valve *recent Hx of invasive procedure (25%) *IV abuse
*structural or congenital heart disease
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