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