Endocarditis is inflammation of your heart's inner lining, called the endocardium. It's usually caused by bacteria. When the inflammation is caused by infection, the condition is called infective endocarditis. Endocarditis is uncommon in people with healthy hearts.

1. ENDOCARDITIS
Dr,.Arjun Patel
MPT, DNHE

3. Definition
 Infective endocarditis is an illness caused by
microbial infection of the cardiac
endothelial surface.

4. Etiology
1. Infection of abnormal valves
 Relatively high risk
 Arotic valve disease
 Mitral regurgitation + stenosis
 Congenital heart disease
 Intermediate risk
 Mitral valve prolapse
 Mitral stenosis

5.  Tricuspid valve disease
 Pulmonary valve disease
 Calcific arotic sclerosis
 Very low risk
 Atrial septal defect
 Cardiac pacemaker
2. Infection of native valves
3. Surgical endocarditis
 Early prosthetic valve endocarditis
 Late Prosthetic valve endocarditis

6. 4. Causative Organisms
 Bacterial:- streptococcus viridian ,
Streptococcus faecalis and staphylococcus
epidermidis
 Non bacterial:-
Ricketssial- coxiella burnetti
Fungal - Candida

7. Pathophysiology

9. Clinical features
 Fever : variable and low grade
 Anaemia : yellow discoloration of skin.
 clubbing : of fingers and toes occurs early.
 splenomegaly
 Arthralgia : sudden transient pain in joint
without any effusion.

12. subconjunctival
haemorrhage

13. patechial
haemorrhages

16. Investigation
 Blood cultures :- blood cultures is positive
by third day
 Urine :- Microscopic hematuria
 Hematology :-May be raised ESR and
raised C- reactive protein.
 Chest x- ray :-Right sided endocarditis ,
with multiple shadows visible due to an
embolic pneumonia.
 ECG :-MI seen on ECG may be due to
coronary embolism.

18. Treatment
A. Antibiotics:-
Bacterial antibiotic:- Penicillin, cephalosporins ,
Aminoglycosid
B.General measures:-
• Complete rest in bed
• High protein diet with added vitamins and iron
• Small repeated blood transfusions if severe
anaemia

19.  Fungal endocarditis :- IV Amphotericin and
surgical excision of prosthetic valves
 surgical measure - indication -
 infection cannot be controlled medically.
 acute or chronic heart as a result of valve
destruction especially aortic valve , septal defects
and major emboli.

20. Reference
 Medicine by Golwalla
 Textbook of pathology by Harsh mohan
 Medicine by Davidson