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Non Infective Endocarditis
Non-infective endocarditis, also known as non-bacterial thrombotic endocarditis (NBTE) or aseptic endocarditis, refers to a rare condition characterised by formation of sterile vegetations. Without treatment, these can lead to valve dysfunction, heart failure, systemic embolism and death.
What is nonbacterial thrombotic endocarditis?
Nonbacterial thrombotic endocarditis (NBTE) is a rare condition that refers to a spectrum of noninfectious lesions of the heart valves that is most commonly seen in advanced malignancy. NBTE is often an autopsy finding.
What are the three types of endocarditis?
Infective endocarditis is divided into the three categories of acute, subacute, and chronic based on the duration of symptoms. Acute infective endocarditis refers to the presence of signs and symptoms of infective endocarditis that are present for days up to six weeks.
What is the difference between infective and bacterial endocarditis?
Infective endocarditis (IE) [also called bacterial endocarditis (BE), or depending on acuity acute or subacute or chronic bacterial endocarditis (SBE) ] occurs when germs (usually bacteria) enter the blood stream and attach to and attack the lining of the heart valves.
What is Libman Sacks endocarditis?
Libman-Sacks endocarditis is a type of sterile nonbacterial thrombotic endocarditis (NBTE) secondary to inflammation. It is the most characteristic cardiac manifestation of the autoimmune disease systemic lupus erythematosus (SLE; lupus).
What is the most common clinical manifestation of infective endocarditis?
Common signs and symptoms of endocarditis include:
- Aching joints and muscles.
- Chest pain when you breathe.
- Fatigue.
- Flu-like symptoms, such as fever and chills.
- Night sweats.
- Shortness of breath.
- Swelling in your feet, legs or abdomen.
What is infective endocarditis?
Infective endocarditis (IE) is an infection of the inner lining of the heart muscle (endocardium) caused by bacteria, fungi, or germs that enter through the bloodstream.
What is the most common complication of infective endocarditis?
Congestive heart failure is the most common serious complication of infective endocarditis and is the leading cause of death among patients with this infection.
What are the stages of infective endocarditis?
Infective endocarditis may have an indolent, subacute course or a more acute, fulminant course with greater potential for rapid decompensation. Subacute bacterial endocarditis (SBE), although aggressive, usually develops insidiously and progresses slowly (ie, over weeks to months).
What is the differential diagnosis for infective endocarditis?
Vascular phenomenon, including major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhage, or Janeway lesions. Immunologic phenomenon such as glomerulonephritis, Osler nodes, Roth spots, and rheumatoid factor.
What three critical elements are required for the pathogenesis of infective endocarditis?
The pathophysiology of infective endocarditis comprises at least three critical elements: preparation of the cardiac valve for bacterial adherence, adhesion of circulating bacteria to the prepared valvular surface, and survival of the adherent bacteria on the surface, with propagation of the infected vegetatlon.
When should you suspect infective endocarditis?
Endocarditis should be suspected in any patient with unexplained fevers, night sweats, or signs of systemic illness, particularly if any of the following risk factors are present1: a prosthetic heart valve, structural or congenital heart disease, intravenous drug use, and a recent history of invasive procedures (e.g., …
What murmur is heard in infective endocarditis?
Acute infective endocarditis
The most common type is an aortic regurgitation murmur.
What are sterile vegetations?
Sterile vegetations form on heart valves in response to factors such as trauma, circulating immune complexes, vasculitis, or a hypercoagulable state. The sterile vegetations can embolize or become infected but rarely impair valvular or cardiac function.
How do you treat Libman-Sacks endocarditis?
No specific therapy is indicated for Libman-Sacks endocarditis. Manage heart failure due to valvular dysfunction according to usual guidelines. Medications may include vasodilators, beta blockers, diuretics, and digoxin.
What causes Libmansacks?
| LibmanSacks endocarditis | |
|---|---|
| Specialty | Rheumatology, Cardiology |
| Symptoms | Nonbacterial thrombotic endocarditis, Marantic endocarditis, verrucous endocarditis |
| Causes | Systemic lupus erythematosus, Malignancy, Antiphospholipid syndrome |
| Diagnostic method | Echocardiography |
What is the most common cause of death in infective endocarditis?
Heart failure and malignancy have been identified as the most frequent long-term causes of death in IE patients [2].
How do you test for infective endocarditis?
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- Blood culture test. A blood culture test is used to identify any germs in your bloodstream. …
- Complete blood count. …
- Echocardiogram. …
- Electrocardiogram (ECG or EKG). …
- Chest X-ray. …
- Computerized tomography (CT) scan or magnetic resonance imaging (MRI).
What is Duke criteria?
The Duke criteria are a set of clinical criteria set forward for the diagnosis of infective endocarditis. For diagnosis the requirement is: 2 major and 1 minor criterion or. 1 major and 3 minor criteria or. 5 minor criteria.
Which valve is damaged in infective endocarditis?
The tricuspid valve is most commonly affected (50%), whereas involvement of the mitral and aortic valves is less common (20% each).
Which of the following is the most common cause of native valve infective endocarditis in the community?
Approximately 70% of infections in NVE are caused by Streptococcus species, including S viridans, Streptococcus bovis, and enterococci. Staphylococcus species cause 25% of cases and generally demonstrate a more aggressive acute course.
Is infective endocarditis fatal?
Endocarditis is a rare and potentially fatal infection of the inner lining of the heart (the endocardium). It’s most commonly caused by bacteria entering the blood and travelling to the heart.
Can a tooth infection cause endocarditis?
A dental problem or procedure that results in an infection can trigger it. Poor health in the teeth or gums increases the risk of endocarditis, as this makes it easier for the bacteria to get in. Good dental hygiene helps prevent heart infection.
What is the outcome possible after infective endocarditis?
Complications of infective endocarditis (IE) include cardiac, metastatic, neurologic, renal, musculoskeletal, and pulmonary complications as well as complications related to systemic infection (including embolization, metastatic infection, and mycotic aneurysm).
What is myocardium infarction?
A heart attack (myocardial infarction) happens when one or more areas of the heart muscle don’t get enough oxygen. This happens when blood flow to the heart muscle is blocked.
Can you have endocarditis and not know?
The symptoms of endocarditis aren’t always severe, and they may develop slowly over time. In the early stages of endocarditis, the symptoms are similar to many other illnesses. This is why many cases go undiagnosed. Many of the symptoms are similar to cases of the flu or other infections, such as pneumonia.
Can infective endocarditis be asymptomatic?
Among the 100 medical records analyzed for emboli in left-sided infective endocarditis, 36 (36%) were found to have had asymptomatic events, 11 (11%) to the central nervous system and 28 (28%) to the spleen. Cardiac surgery was performed in 98/136 (72%).
How long can you live with untreated endocarditis?
Global survival was 75% at 6 months, and 57% at 5 years. The only non-significant factor was IE location. The annual instantaneous risk of death was 0.55 at 6 months, 0.18 at 1 year, then 0.03. After one year, the only prognostic factor was age.
What is the most common type of endocarditis?
Infective endocarditis develops most commonly on the mitral valve, closely followed in descending order of frequency by the aortic valve, the combined mitral and aortic valve, the tricuspid valve, and, rarely, the pulmonic valve. Mechanical prosthetic and bioprosthetic valves exhibit equal rates of infection.
What is mural endocardium?
(my?’r?l en’d?-kahr-d?’tis) Inflammation of the endocardium involving the walls of the chambers of the heart.
Why is the left side of the heart mostly affected by infective endocarditis?
This predilection is believed to be related to the following 3 factors: (1) the relatively higher pressures on the left side of the heart that produce more turbulent flow across the mitral and aortic valves, predisposing them to endothelial damage; (2) the relatively higher oxygen content of the left-side circulation, …
What is the most common causative agent of bacterial endocarditis?
Two kinds of bacteria cause most cases of bacterial endocarditis. These are staphylococci (staph) and streptococci (strep). You may be at increased risk for bacterial endocarditis if you have certain heart valve defects.
What layer of the heart would be most immediately susceptible to infections caused by bacteria?
The correct answer Endocardium.
Which of the heart valve is considered most repairable?
Degenerative mitral valve disease is the most repairable form of surgical mitral valve disease, and repair is the most recommended surgical approach (4).
How do you know if you have a heart infection?
What are the symptoms of a heart infection?
- Chest pain.
- Fatigue.
- Fever.
- Fluid buildup (edema) in the legs, ankles, feet or abdomen.
- Joint pain or body aches.
- Night sweats.
- Rapid heartbeat (arrhythmia) or pounding heartbeat (heart palpitations).
- Shortness of breath (dyspnea).
What is the difference between myocarditis and endocarditis?
Endocarditis is inflammation of the inner lining of the heart’s chambers and valves. Myocarditis is inflammation of the heart muscle.
What does endocarditis look like on Echo?
Three echocardiographic findings were considered to be major criteria for the diagnosis of endocarditis: (1) presence of vegetations defined as mobile echodense masses implanted in a valve or mural endocardium in the trajectory of a regurgitant jet or implanted in prosthetic material with no alternative anatomical …
What causes a Pansystolic murmur?
A second type of systolic murmur is holosystolic (sometimes called pansystolic) because the intensity is high throughout systole as shown in the figure. This type of murmur is caused by mitral or tricuspid regurgitation, or by a ventricular septal defect.
What are Osler nodes?
Osler nodes and Janeway lesions are cutaneous manifestations of endocarditis, a disease most commonly arising from a bacterial or fungal infection of the cardiac endocardium.[1] Osler nodes are tender, purple-pink nodules with a pale center and an average diameter of 1 to 1.5 mm.[2] They are generally found on the …
What is nonbacterial thrombotic endocarditis?
Nonbacterial thrombotic endocarditis (NBTE) is a rare condition that refers to a spectrum of noninfectious lesions of the heart valves that is most commonly seen in advanced malignancy. NBTE is often an autopsy finding.
What causes nonbacterial thrombotic endocarditis?
Non-bacterial thrombotic endocarditis (NBTE) or marantic endocarditis is a non-infectious process affecting normal or degenerative cardiac valves that is due to fibrin thrombi deposits in patients with hypercoagulable states associated with adenocarcinomas of the lung, colon, or pancreas that produce mucin.
What does Marantic mean?
Adjective. marantic (comparative more marantic, superlative most marantic) (medicine) Pertaining to, suffering from or marked by marasmus. Synonym: marasmic.
How is Libman-Sacks endocarditis diagnosed?
A diagnostic workup including chemistries, complete blood count, blood cultures, chest x-ray, and 2-D echocardiogram was performed to determine the etiology of her symptoms and differentiate between acute bacterial endocarditis and LibmanSacks endocarditis.
What is the most common clinical manifestation of infective endocarditis?
Common signs and symptoms of endocarditis include:
- Aching joints and muscles.
- Chest pain when you breathe.
- Fatigue.
- Flu-like symptoms, such as fever and chills.
- Night sweats.
- Shortness of breath.
- Swelling in your feet, legs or abdomen.
What is Libman Sacks syndrome?
Libman-Sacks endocarditis is a type of sterile nonbacterial thrombotic endocarditis (NBTE) secondary to inflammation. It is the most characteristic cardiac manifestation of the autoimmune disease systemic lupus erythematosus (SLE; lupus).
What is infective endocarditis?
Infective endocarditis (IE) is an infection of the inner lining of the heart muscle (endocardium) caused by bacteria, fungi, or germs that enter through the bloodstream.
Does SLE cause infective endocarditis?
Background: Compared with the general population, patients with systemic lupus erythematosus, or SLE, have an increased prevalence of functionally impaired cardiac valves due to the presence of Libman-Sacks lesions. These lesions may place patients with SLE at risk of developing infective endocarditis, or IE.
What is the most frequent etiologic agent of acute infective endocarditis in IV drug abusers?
Infective endocarditis (IE) is one of the most severe complications in intravenous drug abusers (IVDA). IE usually involves the tricuspid valve, Staphylococcus aureus is the most common etiologic agent, and it has a relatively good prognosis.
