Infective endocarditis is caused by bacteria entering the bloodstream and infecting the heart valves, typically presenting with fever, bacteremia, and valvular lesions, and can be either acute, with rapid progression, or subacute, with slower progression; it is diagnosed through blood cultures, echocardiography, and clinical criteria, and treated with prolonged antibiotic therapy targeted to the causative organism along with potential surgery for complications.
Infective endocarditis is a serious infection of the heart valves or endocardium that is usually caused by bacteria entering the bloodstream. It requires prolonged antibiotic treatment and sometimes surgery to address complications. Diagnosis involves blood cultures, echocardiography to identify vegetations or abscesses, and application of the modified Duke criteria. Complications can include embolisms, metastatic infections, immune complex disease, and valve destruction. Prevention relies on antibiotic prophylaxis for certain dental and surgical procedures for at-risk patients.
Infective endocarditis is a microbial infection of the heart valves or endocardium. It can be acute or subacute depending on the virulence of the organism and host factors. Common symptoms include fever, heart murmur, and embolic phenomena. Diagnosis involves blood cultures, echocardiogram, and applying the Duke criteria. Treatment is with prolonged antibiotic therapy tailored to the identified organism. Surgery may be needed for complications or uncontrolled infection. Infective endocarditis has a high mortality rate around 25% depending on the organism and underlying heart condition.
This document discusses infective endocarditis, including its definitions, epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention. Some key points include:
- It involves microbial infection of the heart valves and is usually caused by bacteria like streptococci, staphylococci, and enterococci.
- Common symptoms include fever and heart murmur. Potential complications include heart failure, embolisms, and metastatic abscesses.
- Diagnosis involves blood cultures, echocardiography, and published clinical criteria.
- Treatment involves antibiotics tailored to the infecting organism, with surgery for complications or high-risk cases.
- Prevention focuses on antibiotic prophylaxis for high-risk
infective endocarditis c1.pptx Cardiovacsular system infectionAbdulkadirHasan
Infective endocarditis is a serious infection of the heart valves. It occurs when bacteria enter the bloodstream and attach to areas of abnormal heart tissue. Symptoms may include fever, heart murmur, petechiae, and heart failure. Diagnosis is made using the modified Duke criteria and involves blood cultures, echocardiogram, and clinical features. Common causes are viridans streptococci and staphylococci. Treatment involves intravenous antibiotics for 4-6 weeks to prevent complications like emboli, heart failure, and death. Long term antibiotic therapy and surgery may be needed for complex cases or persistent infection. Preventive antibiotics are given before some medical procedures to reduce the risk of infective endocard
The document discusses infective endocarditis, including:
1. Vegetations form on heart valves from bacterial deposition, usually due to a susceptible cardiovascular substrate and source of bacteremia. Common causes are streptococcus, staphylococcus, and enterococcus.
2. Predisposing factors include age, pre-existing heart conditions, dental procedures, injection drug use, and medical implants.
3. Treatment involves antibiotics to eradicate the infection and sometimes surgery for complications. Outcomes depend on the causative organism and severity of cardiac involvement.
This document provides an overview of infective endocarditis, including:
- It defines infective endocarditis and discusses its history and evolution.
- It covers the epidemiology, classification, predisposing factors, pathogenesis, signs/symptoms, diagnosis, treatment, complications, and prognosis of infective endocarditis.
- It provides details on the various types of infective endocarditis including native valve, prosthetic valve, intravenous drug abuse, nosocomial, and pacemaker infective endocarditis.
This document discusses infective endocarditis, including its epidemiology, pathophysiology, clinical features, diagnosis, treatment, and prevention. Some key points:
- Native valve endocarditis most commonly affects the mitral valve and has a mortality of 16-27% with treatment. Risk factors include IV drug use, poor dental hygiene, and underlying heart conditions.
- Prosthetic valve endocarditis has higher mortality rates of 30-80% for early infection and 20-40% for late infection.
- Common causative organisms include Staphylococcus aureus, streptococci, and enterococci. Fungal and HACEK organisms are also possible.
- Diagnosis
Infective endocarditis is a microbial infection of the heart valves or intracardiac devices. It is classified as either acute or subacute based on clinical presentation. Acute IE is caused by pyogenic bacteria and results in sepsis, while subacute IE is usually caused by Streptococcus viridans. Diagnosis relies on the modified Duke criteria and blood cultures, while echocardiography can identify valvular vegetations. Common manifestations include fever, heart murmurs, embolic phenomena, and immunological findings such as Roth spots.
Infective endocarditis is a serious infection of the heart valves or endocardium that is usually caused by bacteria entering the bloodstream. It requires prolonged antibiotic treatment and sometimes surgery to address complications. Diagnosis involves blood cultures, echocardiography to identify vegetations or abscesses, and application of the modified Duke criteria. Complications can include embolisms, metastatic infections, immune complex disease, and valve destruction. Prevention relies on antibiotic prophylaxis for certain dental and surgical procedures for at-risk patients.
Infective endocarditis is a microbial infection of the heart valves or endocardium. It can be acute or subacute depending on the virulence of the organism and host factors. Common symptoms include fever, heart murmur, and embolic phenomena. Diagnosis involves blood cultures, echocardiogram, and applying the Duke criteria. Treatment is with prolonged antibiotic therapy tailored to the identified organism. Surgery may be needed for complications or uncontrolled infection. Infective endocarditis has a high mortality rate around 25% depending on the organism and underlying heart condition.
This document discusses infective endocarditis, including its definitions, epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention. Some key points include:
- It involves microbial infection of the heart valves and is usually caused by bacteria like streptococci, staphylococci, and enterococci.
- Common symptoms include fever and heart murmur. Potential complications include heart failure, embolisms, and metastatic abscesses.
- Diagnosis involves blood cultures, echocardiography, and published clinical criteria.
- Treatment involves antibiotics tailored to the infecting organism, with surgery for complications or high-risk cases.
- Prevention focuses on antibiotic prophylaxis for high-risk
infective endocarditis c1.pptx Cardiovacsular system infectionAbdulkadirHasan
Infective endocarditis is a serious infection of the heart valves. It occurs when bacteria enter the bloodstream and attach to areas of abnormal heart tissue. Symptoms may include fever, heart murmur, petechiae, and heart failure. Diagnosis is made using the modified Duke criteria and involves blood cultures, echocardiogram, and clinical features. Common causes are viridans streptococci and staphylococci. Treatment involves intravenous antibiotics for 4-6 weeks to prevent complications like emboli, heart failure, and death. Long term antibiotic therapy and surgery may be needed for complex cases or persistent infection. Preventive antibiotics are given before some medical procedures to reduce the risk of infective endocard
The document discusses infective endocarditis, including:
1. Vegetations form on heart valves from bacterial deposition, usually due to a susceptible cardiovascular substrate and source of bacteremia. Common causes are streptococcus, staphylococcus, and enterococcus.
2. Predisposing factors include age, pre-existing heart conditions, dental procedures, injection drug use, and medical implants.
3. Treatment involves antibiotics to eradicate the infection and sometimes surgery for complications. Outcomes depend on the causative organism and severity of cardiac involvement.
This document provides an overview of infective endocarditis, including:
- It defines infective endocarditis and discusses its history and evolution.
- It covers the epidemiology, classification, predisposing factors, pathogenesis, signs/symptoms, diagnosis, treatment, complications, and prognosis of infective endocarditis.
- It provides details on the various types of infective endocarditis including native valve, prosthetic valve, intravenous drug abuse, nosocomial, and pacemaker infective endocarditis.
This document discusses infective endocarditis, including its epidemiology, pathophysiology, clinical features, diagnosis, treatment, and prevention. Some key points:
- Native valve endocarditis most commonly affects the mitral valve and has a mortality of 16-27% with treatment. Risk factors include IV drug use, poor dental hygiene, and underlying heart conditions.
- Prosthetic valve endocarditis has higher mortality rates of 30-80% for early infection and 20-40% for late infection.
- Common causative organisms include Staphylococcus aureus, streptococci, and enterococci. Fungal and HACEK organisms are also possible.
- Diagnosis
Infective endocarditis is a microbial infection of the heart valves or intracardiac devices. It is classified as either acute or subacute based on clinical presentation. Acute IE is caused by pyogenic bacteria and results in sepsis, while subacute IE is usually caused by Streptococcus viridans. Diagnosis relies on the modified Duke criteria and blood cultures, while echocardiography can identify valvular vegetations. Common manifestations include fever, heart murmurs, embolic phenomena, and immunological findings such as Roth spots.
Infective endocarditis is an infection of the heart valves or endocardium. It occurs at a rate of 10,000-20,000 cases per year in the US. Staphylococcus aureus is the most common cause. Diagnosis is made using the Modified Duke Criteria which considers blood culture results, echocardiogram findings, and clinical features. Treatment involves prolonged antibiotic therapy for 4-6 weeks depending on the causative organism. Surgery may be required for complications or refractory infection. Prophylaxis with antibiotics is recommended for certain high risk dental and surgical procedures to prevent bacteremia and seeding of valves.
Infective endocarditis is an inflammatory process of the endocardium caused by bacterial infection. It most commonly involves the aortic and mitral valves. Despite advances in diagnosis and treatment, mortality remains high, particularly in critically ill patients. The epidemiology, pathogens, and presentation of infective endocarditis have changed over time. Complications include heart failure, embolic events, uncontrolled infection, and major extracardiac complications. A multidisciplinary team approach is important for the diagnosis, treatment, and management of this condition.
This document discusses infective endocarditis (IE), including its epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prophylaxis. Some key points:
- IE incidence is increasing in those over age 60 and is associated with prosthetic valves, intravenous drug use, and nosocomial infections.
- Staphylococcus aureus is the most common cause. IE involves bacterial seeding of heart valves, often where endothelial cells are damaged.
- Symptoms include fever, weight loss, heart murmurs, and embolic phenomena. Diagnosis involves blood cultures, echocardiography, and applying the Modified Duke Criteria.
- Treatment involves prolonged intravenous antibiotics, often in combination,
Infective endocarditis is an inflammatory process of the endocardium caused by bacterial infection. It most commonly involves the aortic and mitral valves. It carries a risk of serious complications and high mortality, particularly in critically ill patients. The document discusses the epidemiology, pathophysiology, clinical presentation, diagnostic approach, prevention, treatment including antimicrobial and surgical management, prognosis, and specific considerations for prosthetic valve endocarditis and cardiac device-related infective endocarditis. Key points include changing epidemiology, virulent organisms like Staphylococcus aureus carrying high risks, various clinical manifestations, importance of early diagnosis and treatment to prevent complications like heart failure, embolism and uncontrolled
Infective endocarditis is an infection of the heart valves or endocardial surfaces. It most commonly involves the mitral and aortic valves. Staphylococcus aureus is the most common cause of acute infective endocarditis while viridans streptococci most commonly cause subacute infective endocarditis. Diagnosis requires a high index of suspicion and is confirmed through blood cultures, echocardiography, and applying modified Duke criteria. Treatment involves prolonged intravenous antibiotics targeting the causative organism along with surgery to address valvular complications or poor prognostic factors. Prevention strategies focus on proper dental and skin care to reduce risk of infection from procedures.
Infective Endocarditis is a microbial infection of the heart valves or inner lining of the heart. It is most commonly caused by bacteria and can lead to the formation of vegetations on the heart valves. The diagnosis is based on the modified Duke criteria which incorporates blood culture results, echocardiography findings and clinical features such as fever, heart murmur and embolic phenomena. Early diagnosis is important to guide treatment, which typically involves prolonged intravenous antibiotics.
This document provides an overview of infective endocarditis, including its definition, pathogenesis, epidemiology, clinical presentation, diagnosis, and treatment. It defines infective endocarditis as a microbial infection of the heart valves or endocardium. It discusses the typical pathogens involved and describes the formation of vegetations on heart valves. It also outlines the diagnostic criteria, including blood cultures and echocardiography. Treatment involves prolonged antibiotic therapy tailored to the causative organism, and may require surgery in cases of heart failure or uncontrolled infection.
Infective endocarditis is an infection of the inner lining of the heart (endocardium) that involves the heart valves and adjacent structures. It is caused by bacteria or fungi entering the bloodstream and can lead to heart valve damage or death. Common symptoms include fever, fatigue, heart murmur. Diagnosis involves blood cultures, echocardiogram, and the modified Duke criteria. Treatment involves antibiotic therapy, which depends on the identified organism. Prevention focuses on proper dental hygiene and antibiotic prophylaxis for certain at-risk patients before invasive procedures.
Infective Endocarditis is an infection of the inner lining of the heart caused by bacteria or fungi. It involves the heart valves, mural endocardium, or intracardiac devices. It is classified as acute or subacute based on the virulence of the organism and progression of symptoms. Predisposing factors include rheumatic heart disease and prosthetic valves. Diagnosis is based on modified Dukes criteria using blood cultures, echocardiography, and clinical signs. Treatment involves antibiotic therapy targeting the identified organism along with surgery in some cases. Endocarditis prophylaxis is recommended for high risk patients undergoing certain medical procedures.
This document provides an overview of infective endocarditis. It defines infective endocarditis as a microbial infection of the endothelial heart surface or intracardiac devices. It discusses the epidemiology, classification, pathogenesis, clinical features, diagnostic criteria, investigations, treatment, and prophylaxis of the condition. The most common causes are streptococci, staphylococci and enterococci bacteria. Infective endocarditis can be native or prosthetic valve endocarditis. If left untreated, it can be fatal in 20-100% of cases depending on diagnosis and treatment. Echocardiography is important for diagnosis, and treatment involves antibiotics tailored to the infecting organism.
Infective Endocarditis and It's Surgical ManagementAlireza Kashani
This document defines and describes infective endocarditis. Key points include:
- Infective endocarditis involves infection of the heart valves or structures, most commonly the valves. This can lead to valvular dysfunction, sepsis, or embolism.
- The infection involves bacterial, viral, or fungal invasion of the endocardium and formation of vegetations on the valves or endocardium.
- Risk factors include underlying heart conditions, IV drug use, dental procedures, and indwelling catheters. The aortic and mitral valves are most commonly involved.
- Symptoms may include fever, heart murmur, embolic phenomena, and heart failure. Diagnosis
This document discusses infective endocarditis, including trends, classifications, microbiology, pathogenesis, clinical manifestations, diagnosis and treatment. Some key points:
- IE is an infection of the heart valves or endocardium that is usually caused by bacteria. Common predisposing factors include rheumatic heart disease and intravenous drug use.
- It is classified based on several factors such as the site of infection, causative organism, and underlying risk factors. Acute IE has a rapid course while subacute IE progresses more slowly.
- Common symptoms include heart murmurs, heart failure, embolic phenomena affecting organs like the brain, lungs and kidneys. Specific findings include petechiae, splinter
Infective endocarditis is a microbial infection of the heart that has proven difficult to treat as its incidence and mortality have not decreased in recent decades despite medical advances. It presents in various forms depending on factors like the microorganism, underlying heart condition, and patient characteristics. Guidelines are often based on expert opinion due to the low incidence of the disease and lack of randomized trials.
Infective Endocarditis is an infection of the inner lining of the heart caused by bacteria or fungi. It usually involves the heart valves. It is classified as either acute or subacute based on the virulence of the infecting organism and clinical course. Common predisposing factors are rheumatic heart disease and prosthetic heart valves. Staphylococcus aureus is the most common cause. Diagnosis is based on modified Dukes criteria using positive blood cultures, echocardiographic findings, and clinical features. Treatment involves long-term intravenous antibiotics and may require surgery for complications or poorly responsive infections. Endocarditis prophylaxis is recommended for certain high risk groups before invasive procedures.
Infective endocarditis is an infection of the heart valves or endocardium. It can be classified as native valve, prosthetic valve, intravenous drug abuse related, or nosocomial acquired. Common symptoms include fever, heart murmur, petechiae, and splinter hemorrhages. Blood cultures and echocardiography are used to diagnose. Treatment involves parenteral antibiotics for 4-6 weeks along with possible surgery. Complications can be embolic, from local spread of infection, metastatic spread, or immune complex formation leading to glomerulonephritis. Prevention focuses on antibiotic prophylaxis for high risk patients before certain medical procedures.
Infective endocarditis is an infection of the heart valves. It can affect native or prosthetic valves. Common causes are streptococci and staphylococci bacteria. Diagnosis involves blood cultures, echocardiogram, and application of the Duke criteria. Treatment involves intravenous antibiotics for 2-6 weeks along with surgery if needed for complications. Prognosis depends on the causative organism and underlying heart condition.
Infective endocarditis is a microbial infection of the heart valves or endocardium. It is characterized by pathological vegetations composed of platelets, fibrin, microorganisms, and inflammatory cells. It occurs more commonly in males and the elderly. It can be acute, affecting normal valves rapidly, or subacute, often affecting damaged valves in a slower manner. Bacteria enter the bloodstream and attach to platelet-fibrin deposits on damaged heart valves. Diagnosis involves blood cultures, echocardiography, and applying the Duke criteria. Complications include embolisms, local or metastatic infection spread, and immune complex disease. Treatment involves antibiotics, sometimes with surgery. High-risk patients may receive antibiotic prophylaxis
Infective endocarditis by Dr. Basil Tumaini and Dr. Shamsherali EbrahimBasil Tumaini
Infective endocarditis is an infection of the heart valves or endocardium. It can involve one or more valves or the inner lining of the heart. This document provides definitions and classifications of infective endocarditis and discusses its epidemiology, microbiology, pathophysiology, clinical features, diagnosis, and treatment. Treatment involves antimicrobial therapy targeting the likely causative pathogens, with combinations of drugs preferred over monotherapy to achieve bactericidal concentrations and potentially shorten treatment duration. Surgery may also be required to treat sequelae of intracardiac lesions.
Infective endocarditis is a microbial infection of the heart valves or endocardium. It is characterized by the formation of vegetations composed of platelets, fibrin, microorganisms, and inflammatory cells. It occurs more commonly in males and the elderly. Streptococci and Staphylococcus aureus are the most common causes. Diagnosis involves blood cultures, echocardiography, and applying the Duke criteria. Complications include embolisms, heart failure, and metastatic infections. Treatment involves prolonged antibiotic therapy targeted to the infecting organism. Surgery may be needed for complications or uncontrolled infection. Antibiotic prophylaxis is now restricted to highest risk patients undergoing highest risk procedures.
IEC PROTOCOL DR SAMEER PURRA CARDIOLOGY.pptpurraSameer
This document provides details regarding a proposed study on the clinical and angiographic profile of armed force personnel presenting with acute coronary syndrome (ACS) at SKIMS in Srinagar, Jammu and Kashmir. The study involves a single center and will accrue 50 patients over 24 months from September 2022. The primary objectives are to assess the clinical and angiographic profile of armed force personnel with ACS and correlate various demographic, clinical and biochemical variables with coronary artery disease burden. Secondary objectives include determining clinical outcomes at 7 and 30 days post-event, comparing incidence of ACS across armed force groups, and correlating stress levels using a validated questionnaire.
31273_coarctation of aorta; catheter interventions icc 2008.pptpurraSameer
This document discusses different treatment options for coarctation of the aorta, including surgery and transcatheter interventions like balloon angioplasty and stenting. It provides details on:
1) The risks and outcomes of surgical repair for coarctation of the aorta in infants and children, including mortality rates ranging from 0-15% and morbidities.
2) Studies showing balloon angioplasty and stenting as alternatives to surgery, with benefits including lower risks of recoarctation, aneurysm formation, and reintervention.
3) Results from studies demonstrating the safety and effectiveness of balloon angioplasty and stenting for native and recurrent coarctation, with significant reduction in
Infective endocarditis is an infection of the heart valves or endocardium. It occurs at a rate of 10,000-20,000 cases per year in the US. Staphylococcus aureus is the most common cause. Diagnosis is made using the Modified Duke Criteria which considers blood culture results, echocardiogram findings, and clinical features. Treatment involves prolonged antibiotic therapy for 4-6 weeks depending on the causative organism. Surgery may be required for complications or refractory infection. Prophylaxis with antibiotics is recommended for certain high risk dental and surgical procedures to prevent bacteremia and seeding of valves.
Infective endocarditis is an inflammatory process of the endocardium caused by bacterial infection. It most commonly involves the aortic and mitral valves. Despite advances in diagnosis and treatment, mortality remains high, particularly in critically ill patients. The epidemiology, pathogens, and presentation of infective endocarditis have changed over time. Complications include heart failure, embolic events, uncontrolled infection, and major extracardiac complications. A multidisciplinary team approach is important for the diagnosis, treatment, and management of this condition.
This document discusses infective endocarditis (IE), including its epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prophylaxis. Some key points:
- IE incidence is increasing in those over age 60 and is associated with prosthetic valves, intravenous drug use, and nosocomial infections.
- Staphylococcus aureus is the most common cause. IE involves bacterial seeding of heart valves, often where endothelial cells are damaged.
- Symptoms include fever, weight loss, heart murmurs, and embolic phenomena. Diagnosis involves blood cultures, echocardiography, and applying the Modified Duke Criteria.
- Treatment involves prolonged intravenous antibiotics, often in combination,
Infective endocarditis is an inflammatory process of the endocardium caused by bacterial infection. It most commonly involves the aortic and mitral valves. It carries a risk of serious complications and high mortality, particularly in critically ill patients. The document discusses the epidemiology, pathophysiology, clinical presentation, diagnostic approach, prevention, treatment including antimicrobial and surgical management, prognosis, and specific considerations for prosthetic valve endocarditis and cardiac device-related infective endocarditis. Key points include changing epidemiology, virulent organisms like Staphylococcus aureus carrying high risks, various clinical manifestations, importance of early diagnosis and treatment to prevent complications like heart failure, embolism and uncontrolled
Infective endocarditis is an infection of the heart valves or endocardial surfaces. It most commonly involves the mitral and aortic valves. Staphylococcus aureus is the most common cause of acute infective endocarditis while viridans streptococci most commonly cause subacute infective endocarditis. Diagnosis requires a high index of suspicion and is confirmed through blood cultures, echocardiography, and applying modified Duke criteria. Treatment involves prolonged intravenous antibiotics targeting the causative organism along with surgery to address valvular complications or poor prognostic factors. Prevention strategies focus on proper dental and skin care to reduce risk of infection from procedures.
Infective Endocarditis is a microbial infection of the heart valves or inner lining of the heart. It is most commonly caused by bacteria and can lead to the formation of vegetations on the heart valves. The diagnosis is based on the modified Duke criteria which incorporates blood culture results, echocardiography findings and clinical features such as fever, heart murmur and embolic phenomena. Early diagnosis is important to guide treatment, which typically involves prolonged intravenous antibiotics.
This document provides an overview of infective endocarditis, including its definition, pathogenesis, epidemiology, clinical presentation, diagnosis, and treatment. It defines infective endocarditis as a microbial infection of the heart valves or endocardium. It discusses the typical pathogens involved and describes the formation of vegetations on heart valves. It also outlines the diagnostic criteria, including blood cultures and echocardiography. Treatment involves prolonged antibiotic therapy tailored to the causative organism, and may require surgery in cases of heart failure or uncontrolled infection.
Infective endocarditis is an infection of the inner lining of the heart (endocardium) that involves the heart valves and adjacent structures. It is caused by bacteria or fungi entering the bloodstream and can lead to heart valve damage or death. Common symptoms include fever, fatigue, heart murmur. Diagnosis involves blood cultures, echocardiogram, and the modified Duke criteria. Treatment involves antibiotic therapy, which depends on the identified organism. Prevention focuses on proper dental hygiene and antibiotic prophylaxis for certain at-risk patients before invasive procedures.
Infective Endocarditis is an infection of the inner lining of the heart caused by bacteria or fungi. It involves the heart valves, mural endocardium, or intracardiac devices. It is classified as acute or subacute based on the virulence of the organism and progression of symptoms. Predisposing factors include rheumatic heart disease and prosthetic valves. Diagnosis is based on modified Dukes criteria using blood cultures, echocardiography, and clinical signs. Treatment involves antibiotic therapy targeting the identified organism along with surgery in some cases. Endocarditis prophylaxis is recommended for high risk patients undergoing certain medical procedures.
This document provides an overview of infective endocarditis. It defines infective endocarditis as a microbial infection of the endothelial heart surface or intracardiac devices. It discusses the epidemiology, classification, pathogenesis, clinical features, diagnostic criteria, investigations, treatment, and prophylaxis of the condition. The most common causes are streptococci, staphylococci and enterococci bacteria. Infective endocarditis can be native or prosthetic valve endocarditis. If left untreated, it can be fatal in 20-100% of cases depending on diagnosis and treatment. Echocardiography is important for diagnosis, and treatment involves antibiotics tailored to the infecting organism.
Infective Endocarditis and It's Surgical ManagementAlireza Kashani
This document defines and describes infective endocarditis. Key points include:
- Infective endocarditis involves infection of the heart valves or structures, most commonly the valves. This can lead to valvular dysfunction, sepsis, or embolism.
- The infection involves bacterial, viral, or fungal invasion of the endocardium and formation of vegetations on the valves or endocardium.
- Risk factors include underlying heart conditions, IV drug use, dental procedures, and indwelling catheters. The aortic and mitral valves are most commonly involved.
- Symptoms may include fever, heart murmur, embolic phenomena, and heart failure. Diagnosis
This document discusses infective endocarditis, including trends, classifications, microbiology, pathogenesis, clinical manifestations, diagnosis and treatment. Some key points:
- IE is an infection of the heart valves or endocardium that is usually caused by bacteria. Common predisposing factors include rheumatic heart disease and intravenous drug use.
- It is classified based on several factors such as the site of infection, causative organism, and underlying risk factors. Acute IE has a rapid course while subacute IE progresses more slowly.
- Common symptoms include heart murmurs, heart failure, embolic phenomena affecting organs like the brain, lungs and kidneys. Specific findings include petechiae, splinter
Infective endocarditis is a microbial infection of the heart that has proven difficult to treat as its incidence and mortality have not decreased in recent decades despite medical advances. It presents in various forms depending on factors like the microorganism, underlying heart condition, and patient characteristics. Guidelines are often based on expert opinion due to the low incidence of the disease and lack of randomized trials.
Infective Endocarditis is an infection of the inner lining of the heart caused by bacteria or fungi. It usually involves the heart valves. It is classified as either acute or subacute based on the virulence of the infecting organism and clinical course. Common predisposing factors are rheumatic heart disease and prosthetic heart valves. Staphylococcus aureus is the most common cause. Diagnosis is based on modified Dukes criteria using positive blood cultures, echocardiographic findings, and clinical features. Treatment involves long-term intravenous antibiotics and may require surgery for complications or poorly responsive infections. Endocarditis prophylaxis is recommended for certain high risk groups before invasive procedures.
Infective endocarditis is an infection of the heart valves or endocardium. It can be classified as native valve, prosthetic valve, intravenous drug abuse related, or nosocomial acquired. Common symptoms include fever, heart murmur, petechiae, and splinter hemorrhages. Blood cultures and echocardiography are used to diagnose. Treatment involves parenteral antibiotics for 4-6 weeks along with possible surgery. Complications can be embolic, from local spread of infection, metastatic spread, or immune complex formation leading to glomerulonephritis. Prevention focuses on antibiotic prophylaxis for high risk patients before certain medical procedures.
Infective endocarditis is an infection of the heart valves. It can affect native or prosthetic valves. Common causes are streptococci and staphylococci bacteria. Diagnosis involves blood cultures, echocardiogram, and application of the Duke criteria. Treatment involves intravenous antibiotics for 2-6 weeks along with surgery if needed for complications. Prognosis depends on the causative organism and underlying heart condition.
Infective endocarditis is a microbial infection of the heart valves or endocardium. It is characterized by pathological vegetations composed of platelets, fibrin, microorganisms, and inflammatory cells. It occurs more commonly in males and the elderly. It can be acute, affecting normal valves rapidly, or subacute, often affecting damaged valves in a slower manner. Bacteria enter the bloodstream and attach to platelet-fibrin deposits on damaged heart valves. Diagnosis involves blood cultures, echocardiography, and applying the Duke criteria. Complications include embolisms, local or metastatic infection spread, and immune complex disease. Treatment involves antibiotics, sometimes with surgery. High-risk patients may receive antibiotic prophylaxis
Infective endocarditis by Dr. Basil Tumaini and Dr. Shamsherali EbrahimBasil Tumaini
Infective endocarditis is an infection of the heart valves or endocardium. It can involve one or more valves or the inner lining of the heart. This document provides definitions and classifications of infective endocarditis and discusses its epidemiology, microbiology, pathophysiology, clinical features, diagnosis, and treatment. Treatment involves antimicrobial therapy targeting the likely causative pathogens, with combinations of drugs preferred over monotherapy to achieve bactericidal concentrations and potentially shorten treatment duration. Surgery may also be required to treat sequelae of intracardiac lesions.
Infective endocarditis is a microbial infection of the heart valves or endocardium. It is characterized by the formation of vegetations composed of platelets, fibrin, microorganisms, and inflammatory cells. It occurs more commonly in males and the elderly. Streptococci and Staphylococcus aureus are the most common causes. Diagnosis involves blood cultures, echocardiography, and applying the Duke criteria. Complications include embolisms, heart failure, and metastatic infections. Treatment involves prolonged antibiotic therapy targeted to the infecting organism. Surgery may be needed for complications or uncontrolled infection. Antibiotic prophylaxis is now restricted to highest risk patients undergoing highest risk procedures.
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IEC PROTOCOL DR SAMEER PURRA CARDIOLOGY.pptpurraSameer
This document provides details regarding a proposed study on the clinical and angiographic profile of armed force personnel presenting with acute coronary syndrome (ACS) at SKIMS in Srinagar, Jammu and Kashmir. The study involves a single center and will accrue 50 patients over 24 months from September 2022. The primary objectives are to assess the clinical and angiographic profile of armed force personnel with ACS and correlate various demographic, clinical and biochemical variables with coronary artery disease burden. Secondary objectives include determining clinical outcomes at 7 and 30 days post-event, comparing incidence of ACS across armed force groups, and correlating stress levels using a validated questionnaire.
31273_coarctation of aorta; catheter interventions icc 2008.pptpurraSameer
This document discusses different treatment options for coarctation of the aorta, including surgery and transcatheter interventions like balloon angioplasty and stenting. It provides details on:
1) The risks and outcomes of surgical repair for coarctation of the aorta in infants and children, including mortality rates ranging from 0-15% and morbidities.
2) Studies showing balloon angioplasty and stenting as alternatives to surgery, with benefits including lower risks of recoarctation, aneurysm formation, and reintervention.
3) Results from studies demonstrating the safety and effectiveness of balloon angioplasty and stenting for native and recurrent coarctation, with significant reduction in
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CARDIAC AMYLOIDOSIS a brief review – sameer.pptxpurraSameer
The document describes two case scenarios of patients presenting with cardiac symptoms. The first case involves a 70-year-old man diagnosed with cardiac amyloidosis based on positive Congo red staining on endomyocardial biopsy showing amyloid deposits. Imaging and labs revealed cardiac involvement including heart failure and abnormal cardiac markers. The second case involves a 42-year-old man initially diagnosed with NSTEMI but later found to have malabsorption syndrome based on abnormal labs and imaging. Both cases demonstrate the challenges in diagnosing cardiac amyloidosis.
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A 59-year-old male patient with a history of moderate mitral stenosis, mitral regurgitation, and ostium secundum atrial septal defect underwent a cardiac catheterization study. The study showed right heart disease including a dilated right atrium and right ventricle, moderate mitral stenosis, mitral regurgitation, an ostium secundum atrial septal defect measuring 34 mm, and severe tricuspid regurgitation with a right ventricular systolic pressure over 70 mmHg.
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This patient is a 65-year-old female who presented with a 10-year history of palpitations and 5-year history of dyspnea on exertion. Her functional capacity has declined from NYHA class I to class III over 10 years. Examination revealed signs of right and left heart failure including elevated JVP, peripheral edema, and murmurs suggestive of severe aortic stenosis, mitral regurgitation, tricuspid regurgitation, and patent ductus arteriosus. Laboratory findings included hypoxemia. The patient was diagnosed with severe valvular heart disease, pulmonary arterial hypertension, right ventricular pressure overload, and normal left ventricular function.
clinical and angiographic profilr of armed force personnel presenting as acs....purraSameer
This thesis aims to assess the clinical and angiographic profile of armed force personnel presenting with acute coronary syndrome (ACS) at a tertiary care institute in Jammu and Kashmir, India. A total of 169 armed force personnel with ACS were included in the study. The average age was 47.5 years and most were males. Risk factors like smoking, hypertension, and dyslipidemia were common. Coronary angiography was performed in 83% of patients and percutaneous coronary intervention was performed in 63% of patients. Single vessel disease was seen in 39% of patients. The mortality rate was 7.6% with a procedural mortality of 1.1%.
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1588923212-infective-endocarditis.ppt
1. Infective Endocarditis
• Febrile illness
• Persistent bacteremia
• Characteristic lesion of microbial infection
of the endothelial surface of the heart
– Variable in size
– Amorphous mass of fibrin & platelets
– Abundant organisms
– Few inflammatory cells
The vegetation
2.
3. Infective Endocarditis
• Acute
– Toxic presentation
– Progressive valve destruction & metastatic infection developing
in days to weeks
– Most commonly caused by S. aureus
• Subacute
– Mild toxicity
– Presentation over weeks to months
– Rarely leads to metastatic infection
– Most commonly S. viridans or enterococcus
4. Infective Endocarditis
• Case rate may vary between 2-3 cases /100,000 to as
high as 15-30/100,000 depending on incidence of i.v.
drug abuse and age of the population
– 55-75% of patients with native valve endocarditis (NVE) have
underlying valve abnormalities
• MVP
• Rheumatic
• Congenital
• ASH or:
• i.v. drug abuse
5. Infective Endocarditis
• Case rates
– 7-25% of cases involve prosthetic valves
– 25-45% of cases predisposing condition can
not be identified
6. Infective Endocarditis
• Pediatric population
– The vast majority (75-90%) of cases after the
neonatal period are associated with an underlying
congenital abnormality
• Aortic valve
• VSD
• Tetralogy of Fallot
– Risk of post-op infection in children with IE is 50%
• Microbiology
– Neonates: S. aureus, coagulase negative staph,
group B strep
– Older children: 40% strep, S. aureus
7. Infective Endocarditis
• Adult population
– MVP – prominent predisposing factor
• High prevalence in population
– 2-4%
– 20% in young women
• Accounts for 7 – 30% NVE in cases not related to drug abuse
or nosocomial infection
– Relative risk in MVP ~3.5 – 8.2, largely confined to
patients with murmur, but also increased in men and
patients >45 years old
• MVP with murmur – incidence IE 52/100/000 pt. years
• MVP w/o murmur – incidence IE 4.6/100,000 pt. years
8. Infective Endocarditis
• Adult population
– Rheumatic Heart Disease
• 20 – 25% of cases of IE in 1970’s & 80’s
• 7 – 18% of cases in recent reported series
• Mitral site more common in women
• Aortic site more common in men
– Congenital Heart Disease
• 10 – 20% of cases in young adults
• 8% of cases in older adults
• PDA, VSD, bicuspid aortic valve (esp. in men>60)
9. Infective Endocarditis
• Intravenous Drug Abuse
– Risk is 2 – 5% per pt./year
– Tendency to involve right-sided valves
• Distribution in clinical series
– 46 – 78% tricuspid
– 24 – 32% mitral
– 8 – 19% aortic
– Underlying valve normal in 75 – 93%
– S. aureus predominant organism (>50%, 60-
70% of tricuspid cases)
10. Infective Endocarditis
• Intravenous Drug Abuse
– Increased frequency of gram negative
infection such as P. aeruginosa & fungal
infections
– High concordance of HIV positivity & IE (27-
73%)
• HIV status does not in itself modify clinical picture
• Survival is decreased if CD4 count < 200/mm3
11. Infective Endocarditis
• Prosthetic Valve Endocarditis (PVE)
– 10 – 30% of all cases in developed nations
– Cumulative incidence
• 1.4 – 3.1% at 12 months
• 3.2 – 5.7% at 5 years
– Early PVE – within 60 days
• Nosocomial (s. epi predominates)
– Late PVE – after 60 days
• Community (same organisms as NVE)
12. Infective Endocarditis
• Pathology
– NVE infection is largely confined to leaflets
– PVE infection commonly extends beyond
valve ring into annulus/periannular tissue
• Ring abscesses
• Septal abscesses
• Fistulae
• Prosthetic dehiscence
– Invasive infection more common in aortic
position and if onset is early
13. Distinction between Acute and
Subacute Bacterial Endocarditis
Feature Acute Subacute
Underlying Heart
Disease
Heart may be normal RHD,CHD, etc.
Organism S. aureus, Pneumococcus
S. pyogenes,
Enterococcus
viridans
Streptococci,
Entercoccus
Therapy Prompt, vigorous and initiated
on empirical ground
Can often be delayed
until culture reports and
susceptibilities
available
14. Bacterial Endocarditis
Predisposing Factors
1. Dental manipulation
2. Dental disease (caries, abscess)
3. Extracardiac infection (lung, urinary tract,
4. skin, bone, abscess)
4. Instrumentation (urinary tract, GI tract, IV
infusions)
5. Cardiac surgery
6. Injection drug use
7. None apparent
15. Bacterial Endocarditis
Clinical Features
1. Fever. Antibiotics, salicylates, steroids, severe CHF,
uremia may mask temperature elevations.
2. Murmurs
3. Petechiae and cutaneous manifestations. Roth spots
conjunctival and mucosal petechiae, splinter
hemorrhages, Osler nodes and Janway lesions.
4. Splenomegaly
5. Embolism. Septic or sterile. CNS, spleen, lung, retinal
vessels, coronary artery, large vessels.
6. Renal disease, infarction. Multiple abscesses.
Glomerulonephritis and uremia
7. CHF
8. General. Weight loss, anorexia, debilitation, loss of libido.
16. Bacterial Endocarditis
Laboratory Features
1. Anemia
2. Most commonly elevated WBC
3. ESR elevated, ↓ C′ in patients with
glomerulonephritis
4. Microscopic hematuria
5. Bacteremia. Persistent.≥ 3, ≤ 5 blood
cultures. Aerobic and anaerobic. Different
sites.
17. Bacterial Endocarditis
Therapy and Prophylaxis
1. Prolonged; high dosages; use of
bactericidal drugs
2. Serum antibiotic levels and MBC of the
organism
3. Viridans streptococci, Enterococcus, S.
aureus, S. pneumoniae, S. pyogenes
4. Institution of therapy on empirical grounds
5. Proven negative blood cultures on Abx
6. Prophylaxis: dental extraction, GU.
18. Infective Endocarditis
• Majority of cases caused by streptococcus,
staphylococcus, enterococcus, or fastidious gram
negative cocco-bacillary forms
• Gram negative organisms
– P. aeruginosa most common
– HACEK - slow growing, fastidious organisms that
may need 3 weeks to grow out of culture
• Haemophilus sp.
• Actinobacillus
• Cardiobacterium
• Eikenella
• Kingella
19. Pathophysiology
• Embolization
• Clinically evident 11 – 43% of patients
• Pathologically present 45 – 65%
• High risk for embolization
» Large > 10 mm vegetation
» Hypermobile vegetation
» Mitral vegetations (esp. anterior leaflet)
• Pulmonary (septic) – 65 – 75% of i.v. drug abusers
with tricuspid IE
20. Clinical Features
• Interval between index bacteremia & onset
of sx’s usually < 2 weeks
• May be substantially longer in early PVE
• Fever most common sign
• May be absent in elderly/debilitated pt.
• Murmur present in 80 – 85%
• Generally indication of underlying lesion
• Frequently absent in tricuspid IE
• Changing murmur
27. Clinical Features
• Systemic emboli
• Incidence decreases with effective anti-microbial Rx
• Neurological sequelae
• Embolic stroke 15 – 20% of patients
• Mycotic aneurysm
• Cerebritis
• CHF
• Due to mechanical disruption
• High mortality without surgical intervention
• Renal insufficiency
• Immune complex mediated
• Impaired hemodynamics/drug toxicity
28. Diagnosis
• Published criteria for classification
purposes in clinical studies
• High index of suspicion in patients with
predisposing anatomy or behavior
• Blood cultures
• Echocardiography
– TTE – 60% sensitivity
– TEE – 80 – 95% sensitive
29. Goals of Therapy
Eradicate infection
Definitively treat sequelae of destructive
intra-cardiac and extra-cardiac lesions
30. Antibiotic Therapy
• Treatment tailored to etiologic agent
– Important to note MIC/MBC relationship for
each causative organism and the antibiotic
used
– High serum concentration necessary to
penetrate avascular vegetation
– ID CONSULT EVERY TIME
31. Antibiotic Therapy
• Treatment before blood cultures turn
positive
• Suspected ABE
• Hemodynamic instability
– Neither appropriate nor necessary in patient
with suspected SBE who is hemodynamically
stable
32. Antibiotic Therapy
• Effective antimicrobial treatment should
lead to defervescence within 7 – 10 days
– Persistent fever in:
• IE due to staph, pseudomonas, culture negative
• IE with microvascular complications/major emboli
• Intracardiac/extracardiac septic complications
• Drug reaction
33. Surgical Treatment of Intra-Cardiac
Complications
• NYHA Class III/IV CHF due to valve dysfunction
– Surgical mortality – 20-40%
– Medical mortality – 50-90%
• Unstable prosthetic valve
– Surgical mortality – 15-55%
– Medical mortality – near 100% at 6 months
• Uncontrolled infection
34. Surgical Treatment of Intra-Cardiac
Complications
• Difficult to cure:
– Fungal endocarditis
– Brucella
• S. aureus PVE with any intra-cardiac
complication
• Relapse of PVE after optimal therapy
35. Surgical Treatment of Intra-Cardiac
Complications
• Relative indications
– Perivalvular extension of infection
– Poorly responsive S. aureus NVE
– Relapse of NVE
– Culture negative NVE/PVE with persistent fever (> 10
days)
– Large (> 10mm) or hypermobile vegetation
– Endocarditis due to highly resistant enterococcus
– Embolism despite therapy
44. Chemoprophylaxis
Adult Prophylaxis: Dental, Oral, Respiratory, Esophageal
Standard Regimen
Amoxicillin 2g PO 1h before procedure or
Ampicillin 2g IM/IV 30m before procedure
Penicillin Allergic
Clindamycin
600 mg PO 1h before procedure or
600 mg IV 30m before
Cephalexin OR Cefadroxil 2g PO 1 hour before
Cefazolin 1.0g IM/IV 30 min before procedure
Azithromycin or Clarithromycin 500mg PO 1h before
45. Adult Genitourinary or Gastrointestinal Procedures
High Risk Patients
Standard Regimen
Before procedure (30 minutes):
Ampicillin 2g IV/IM AND
Gentamicin 1.5 mg/kg (MAX 120 mg) IM/IV
After procedure (6 hours later)
Ampicillin 1g IM/IV OR
Amoxicillin 1g PO
Penicillin Allergic
Complete infusion 30 minutes before procedure
Vancomycin 1g IV over 1-2h AND
Gentamicin 1.5 mg/kg IV/IM (MAX 120 mg)
Moderate Risk Patients
Standard Regimen
Amoxicillin 2g PO 1h before OR
Ampicillin 2g IM/IV 30m before
Penicillin Allergic
Vancomycin 1g IV over 1-2h, complete 30m before