This document discusses acquired heart disease. It defines acquired heart disease as conditions affecting the heart and blood vessels that develop during a person's lifetime, unlike congenital heart diseases which are present at birth. It then discusses the etiology, or causes, which can include bacterial or viral infections. It also discusses the pathogenesis, risk factors, clinical manifestations, physical exam findings, and treatment options which include antibiotics, anti-inflammatory medications, and sometimes surgical repairs for childhood heart defects.

1. Acquired Heart Disease
BHAVANA RAJANNA
89A

2. Outline
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• Definition
• Etiology
• Pathogenesis
• Diagnosis and c/f
• Treatment

3. DEFINITION:
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• Acquired heart diseases
are conditions affecting
the heart and its
associated blood vessels
that develop during a
person's lifetime, in
contrast to congenital heart
diseases, which are present
at birth.

5. Etiology
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• They can be caused by illnesses such as a
bacterial or viral infection.
• Viridans type streptococci.
• Staphylococcus aureus,
• Group D enterococci ( lower GI or GU manipulation)
• Others pseudomonas aeruginosa in IVDA

6. Epidemiology
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• Males are commonly affected
• IE is often a complication of congenital or Rheumatic
Heart Disease
• Can occur in children with out any abnormal valves or
cardiac malformation
• In developed countries CHD is commonest
predisposing factor

7. Pathogenesis
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• Patients with CHD where there is a turbulent blood
flow, if there is high pressure gradient across the
defect, turbulent flow Traumatizes the Endothelium,
creates a substrate for deposition of fibrin and
platelets
• Formation of non bacterial thrombotic embolus
which is initiating lesion for IE
• Transient bacteremia there will be colonization of
NBTE by bacteria and Bacterial proliferation occurs

8. Risk factor
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• Intravenous Drug use
• Prosthetic heart valves
• Structural Heart Disease(CHD/RHD)
• Central venous catheter
• Dental, Intestinal or Urinary tract procedure
In 30% a predisposing factor is identified

9. Clinical Manifestation
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• Onset may be acute and severe with HGIF and
prostration
• Prolonged fever without other manifestations
• Common Symptoms are
• Myalgia, arthralgia, headache, nausea and vomiting

10. Physical Examination
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• New/ changing heart murmur
• Splenomegaly
• Signs of Heart Failure
• clubbing
• Classic skin findings develop late in the course of the
disease
• Osler Nodes (tender pea sized intradermal nodules in the pads of
fingers)
• Janeway Leshions (painless small hemorrhagic lesions on palms and soles)
• Splinter Hemorrhages
• This lesions may represent vasculitis prodiced by Ag-Ab Complex

11. Treatment
• Antibiotics: regardless of throat culture result
• Amoxicillin PO for 10 days
• Single IM benzathine penicillin
Anti-inflammatory Therapy:
• Asprin
• corticosteroids

12. Surgical treatment:
• Some childhood heart defects require repairs that can only be
made through open-heart surgery. These repairs may be
needed right away, or they may be delayed for months or even
years. Sometimes repairs can be made in a single surgical
procedure. Other times, a series of operations may be needed.
It all depends on the type and severity of the heart defect and
how sick the patient is.

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