40 Endocarditis

Types and Causes

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• different microbiology for acute and subacute

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• 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

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• 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

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• echodensity

• bacterial growth on valve

Treatment

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Others

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• usually because poor microbiology technique

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• lupus with new murmur

• mucinous adenocarcinoma

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• enterococcus: women after OB, man after prostatic surgery