Infective endocarditis
Description
- Infection of endocardial surface - native valve, prosthetic valve, or cardiac implantable electronic device (CIED)
- Vegetation = platelet-fibrin thrombus + organisms + inflammatory cells
- Avascular, low antibiotic penetration -> prolonged high-dose bactericidal therapy
Classify by
- Valve - native (NVE) vs prosthetic (PVE)
- PVE early (<12 months post-op, nosocomial, CoNS/S. aureus) vs late (community organisms)
- Side - left (embolises systemically) vs right (septic PE, IVDU, CIED)
- Tempo - acute (S. aureus, days, no pre-existing lesion) vs subacute (viridans strep, weeks, abnormal valve)
- Culture status - ~5-10% culture-negative
Key complications
- Valve destruction -> acute regurgitation -> heart failure (commonest cause of death, commonest surgical indication)
- Perivalvular abscess - suspect on new AV block
- Systemic emboli - stroke, splenic/renal infarct, mycotic aneurysm
- Immune complex GN, splenomegaly
6 more sections, plus exam facts
Premium unlocks every note across every specialty, and the full exam fact library behind it.
Get premium access