Cardiac: Endocarditis

Question 1

What is endocarditis? what usually causes it

Answer 1

• inflammation of endocardium that lines the surface of cardiac valves
• bacterial infection

Question 2

What is the most common overall cause of endocarditis? and what does it infect

Answer 2

Streptococcus viridans : low-virulence organism that infects previously damaged valves

Question 3

What diseases involve Streptococcus viridans

Answer 3

• chronic rheumatic heart disease

- mitral valve prolapse

Question 4

Streptococcus viridans results in what

Answer 4

subacute endocarditis: small vegetations do not destroy valve

• damaged endocardial surface develops thrombotic vegetations
• transient bactermia leads to trapping of bacteria in the vegatations

Question 5

what can decrease the risk of endocarditis from streptococcus viridans

Answer 5

prophylactic antibiotics

- ex. dentist office

Question 6

what bacteria is the most common cause of endocarditis in IV drug abuser

Answer 6

Staphylococcus aureus

Question 7

endocarditis from staphylococcus aureus presents how? which valve does it usually attack

Answer 7

• high virulence organism that infects normal valves
• most common valve tricuspid
• results in large vegetations that destroy the valve ( acute endocarditis)

Question 8

Endocarditis of prosthetic valves is associated with what bacteria

Answer 8

Streptococcus epidermidis

Question 9

What bacteria is associated with endocarditis in patients with underlying colorectal carcinoma

Answer 9

Streptococcus bovis

Question 10

what bacteria is associated with endocarditis with negative blood culture

Answer 10

HACEK

Question 11

what does HACEK organisms stand for

Answer 11

Haemophilus
Actinobacillus
Cardiobacterium 
Eikenella 
Kingella

Question 12

What are 4 clinical features of bacterial endocarditis ? and why do we see them?

Answer 12

1. fever - due to bacteremia
2. murmur - due to vegetations on heart valve
3. Janeway lesion, Osler nodes, splinter hemorrhages in nail bed, Roth spots - due to embolization of septic vegetations
4. anemia of chronic disease - due to chronic inflammation

Question 13

Janeway lesion?

Answer 13

erythematous nontender lesions on palms and soles

Question 14

Osler nodes?

Answer 14

tender lesions on fingers and toes

Question 15

What are laboratory findings of endocarditis

Answer 15

1. positive blood cultures
2. Anemia of chronic disease
3. Transesophageal echocardiogram is useful for detecting lesions on valves

Question 16

Nonbacterial thrombotic endocarditis is due to what

Answer 16

sterile vegetations that arise in association with a hypercoagulable state or underlying adenocarcinoma.

Question 17

where do vegetations aries from nonbacterial thrombotic endocarditis? what does this result in?

Answer 17

-mitral valve along lines of closure and result in mitral valve regurgitation

Question 18

What causes Libman-Sacks endocarditis

Answer 18

sterile vegetations that arise in associated with SLE

Question 19

Where does Libman-Sacks present

Answer 19

surface and undersurface of the mitral valve and result in mitral regurgitation