Endocarditis is inflammation of the inner lining of the heart (endocardium) that usually involves the heart valves. It is commonly caused by bacteria like Staphylococcus that enter the bloodstream through invasive procedures or wounds in the mouth, respiratory tract, GI tract, or GU tract. Risk factors include prior heart damage, dental procedures, heart surgery, and certain medical devices. Symptoms include fever, weakness, weight loss, and chest pain. Diagnosis involves blood cultures, echocardiography, and imaging tests. Treatment consists of intravenous antibiotics for 4-6 weeks to eliminate the infecting bacteria.

1. ENDOCARDITIS
A N I L K U M A R B R
L E C T U R E R ( M S N )

3. INTRODUCTION
•The heart is a major vital organ that pumps
blood and it’s has three layers which are
•ENDOCARIDIUM
•MYOCARDIUM
•PERICARDIUM

4. DEFINITION
Endocarditis is characterized by
inflammation of the endocardium it
usually involves the valves of the heart.

5. ETIOLOGY
Common infecting organisms include
“ Staphylococci (s.aureus, s. faecalis and
s.epidermidis.)
“ Fungus, e.g. candida, aspagellus
“gram negative orginsms e.g Pseudomonas
“Bactrias (e.g Staphylococci)

6. CONTINUE
This orginsms enter the body through the
oral cavity after dental procedures, mouth or
tooth abscess, oral irrigations, or irritations
from dental floss or bridge work.

7. CONTINUE
The upper respiratory tract is another port of entry
following conditions.
• Intubations or infectious
• Direct exposure of the blood stream orginsms can occur
with prolonged central line cathter or indwelling urinary
catheter
• Hemodynamic monitoring catheter and IV drug users

8. CONTINUE
Procedure including the gastrointestinal
and genitourinary tracts (e.g barium
enema, sigmoidoscopy, clonoscopy,
Percutaneous liver biopsy have been
associated with endocarditis.

9. RISK FACTORS
• Previous heart damage
• Dental procedures which lead into the introduction
of bactrias
• Heart surgery
• Endotracheal intubation
• Procedure involving the gastrointestinal and
genitourinary tracts

10. PATHOPHYSILOGY
• In this cause of the bactrias or any other
causing agents enter the blood stream through
Invasive procedure like dental procedures,
surgery, Endotracheal intubation and urinary
catheter.
• Then they accumulate on the valves of the
heart or endocardium

11. CONTINUE
• Finally they form vegetations and clusters
• These vegetations they lead into damage heart
valves by perforating and deforming the valves
leaflets
• This at the end leads to tearing which means there
is poor flow of blood and accumulation of blood in
chambers of the heart hence endocarditis

12. CLINICAL MANIFESTATIONS
• Fever, chils alternating with sweats
• Malaise and weakness
• Anorexia and weight loss
• Pallor
• Backache and splenomegally
• Shortness of breath and chest and abdominal pain

13. OTHER SYMPTOMS
•Slernodes (a small, painful nodules on pads
of finger)

15. NAIL HEMORRHAGE (SPLINTER
HEMORRHAGE)
• Small inner hemorrhages under the
nails that are usually asymptotic and
found in some patients.

17. ROTHS SPOTS
• Oval shaped white centerd
hemorrhages present in the retina.

19. ASSASSESSMENT AND DIAGNOSTIC
FINDINGS
• History collection
• Physical examination
• Blood culture
• Urinalysis
• Doppler Echocardiography
• CT scan
• BUN and creatine
• WBC

20. CONTINUE
• ESR
• CRP
•Imagining studies include
• chest x-ray
• ECG and Echocardiography

21. MEDICAL MANAGEMENT
• The main goal of management are to
eradicate the infecting organism in the
vegetation and to treat the
complications.

22. • Antibiotics are the first line treatment of
infective endocarditis.
• Penicillin plus, ceftriaxone and getamycin or
vancomycin is commonly used.
• Antibiotics therapy is usually administered by
the IV route and continued for 4 to 6 weeks.