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