Infective Endocarditis
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This document discusses several topics: - Types of infective endocarditis based on location and causative organism. - Modified Duke's criteria for diagnosing infective endocarditis. - Modified Framingham criteria for diagnosing congestive heart failure which requires two major criteria or one major and two minor criteria. - Components to include when writing a complete diagnosis of congestive heart failure. - Mnemonics (SLAM, CIA, MICH) listing respiratory, cardiovascular, and gastrointestinal causes of clubbing.
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- 2. Native valve IE – mitral (staph) ABE HAIE – >72 hr &w in 60 dys S.au CAIE – Strepto SABE S.virid Prosthetic valve endo Early - <2mth,2-12 mth – CONS Late – S.virid IVD abusers S.aureus Left sided IE (R> L shunt) e.g. PFO S. au & enterococci
- 5. MODIFIED FRAMINGHAMS CRITERIA FOR DIAGNOSIS OF CHF DX =2 MAJOR OR 1 MAJOR AND TWO MINOR CRITERIA NOT ATTRIBUTED TO OTHER MEDICAL CONDITIONS Major criteria Paroxysmal nocturnal dyspnea Orthopnea Elevated JVP Third heart sound Pulmonary rales Cardiomegally on chest x ray Pulmonary edema on chest x ray Weight loss >= 4.5 kg in five days in response to treatment of presumed CHF 5
- 6. Minor criteria Bilateral leg edema Nocturnal cough Dyspnea on ordinary exertion Hepatomegaly Pleural effusion Tachycardia ( HR >= 120 bpm) Weight loss > = 4.5 kg in five days 6
- 7. WRITING COMPLETE DX OF CHF
- 10. Respiratory causes (SLAM) Suppurative lung disease (bronchiectasis, cystic fibrosis, empyema, lung abscess) Lung cancer Alveolitis (fibrosing) Mesothelioma Cardiovascular causes (CIA) Cyanotic heart disease Infective endocarditis Atrial myxoma Gastrointestinal causes (MICH) Malabsorption (coeliac disease) IBD (UC/Crohn’s disease) Cancer of esophagus, liver, bowel Hepatic cirrhosis Clubbing causes