40 Endocarditis
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Types and Causes
- different microbiology for acute and subacute
- staph epidermis: coagulase negative
- binds to normal valve, no damage needed
- express tissue factor, coagulation cascade
- dextran adheres to fibrin that only appears on damaged endothelium
- MVP risk
Symptoms
- new heart murmur classic indication. Aortic regurgitation from valvular damage
- small red spots on skin
- a piece can break off and travel
- splenic infarct: arterial thrombosis. Rare, also seen in lupus
- immune response result in small complex deposition
- Jane is nice person, not painful
- abscess: bacteria developed pocket, usually at root of valve, lies right near AV node
- new prolonged PR
Diagnosis
- echodensity
- bacterial growth on valve
Treatment
Others
- usually because poor microbiology technique
- lupus with new murmur
- mucinous adenocarcinoma
- enterococcus: women after OB, man after prostatic surgery
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