Medical history (history of illness) is an important component in the diagnosis of endocarditis (inflammation of the inner lining of the heart). Family history What is the general health of your family members? Is there a frequent occurrence of heart disease in your family? Social anamnesis Current medical history/systemic history (somatic and psychological complaints). Do … Endocarditis: Medical History
Respiratory System (J00-J99). Bronchiectasis (synonym: bronchiectasis)-permanent irreversible saccular or cylindrical dilatation of the bronchi (medium-sized airways) that may be congenital or acquired; symptoms: chronic cough with “mouthful expectoration” (large-volume triple-layered sputum: foam, mucus, and pus), fatigue, weight loss, and decreased exercise capacity Chronic pneumonia (pneumonia). Otitis media (inflammation of the middle ear) Sinusitis maxillaris (maxillary … Endocarditis: Or something else? Differential Diagnosis
Recommendations for endocarditis prophylaxis were amended by the American Heart Association in 2007 and supplemented by the European Society of Cardiology in 2009/2015. In which patients should endocarditis prophylaxis be given: Patients with prosthetic heart valves/reconstructed heart valves with alloprosthetic material. Patients with condition after endocarditis Patients with congenital heart defects Uncorrected cyanotic heart defects … Endocarditis: Preventive Measures
The following are the most important diseases or complications that may be contributed to by endocarditis (endocarditis): Eyes and eye appendages (H00-H59). Retinal microemboli (retinal vascular occlusions; embolic in origin). Retinal hemorrhages (retinal hemorrhages). Cardiovascular system (I00-I99) Bacterial microembolism – can cause infarction to any organ. Heart failure (cardiac insufficiency) Heart valve rupture Heart valve … Endocarditis: Complications
Duke criteria are a diagnostic scheme for clinical diagnosis of infective endocarditis (IE). To confirm the diagnosis, 2 major criteria, one major criterion and 3 minor criteria, or 5 minor criteria or must be present. Main criteria Secondary criteria Positive cultural detection of typical pathogens (microorganisms that can typically cause IE). Evidence of endocardial involvement/interventricular … Endocarditis: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination-including blood pressure, pulse, body temperature, body weight, height [weight loss]; further: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye) [petechiae (skin bleeding)]. Extremities [due tosymptoms: Janeway lesions (pathogenesis is based on a type III hypersensitivity reaction) … Endocarditis: Examination
1st-order laboratory parameters-obligatory laboratory tests. Small blood count [leukocytosis/increase in white blood cells in blood] Differential blood count [left shift/increased neutrophilic rod-nucleated granulocytes (rod-nucleated neutrophils) or their progenitor cells in peripheral blood] Inflammatory parameters – CRP (C-reactive protein). Electrolytes – sodium, potassium, calcium. Urine status (rapid test for: Nitrite, protein, hemoglobin, erythrocytes, leukocytes, urobilinogen) incl. … Endocarditis: Test and Diagnosis
Therapeutic Targets Avoidance of complications Healing of the disease Therapy recommendations Therapy for endocarditis depends on the etiology (cause). Abacterial endocarditis: therapy of the underlying disease. Infective endocarditis: intravenous antibiotics as first-line therapy (start immediately after blood cultures are taken): Initially calculated until blood culture results, then therapy correction if necessary. In clinically stable patients, … Endocarditis: Drug Therapy
Mandatory medical device diagnostics. Electrocardiogram (ECG; recording of the electrical activity of the heart muscle). Transesophageal echocardiography (TEE; examination is performed via the esophagus, which runs in a section directly next to the heart) – to detect possible valvular vegetations and valve destruction Optional medical device diagnostics – depending on the results of the history, … Endocarditis: Diagnostic Tests
Surgical repair is necessary for: Endocarditis with severe heart failure (cardiac insufficiency). Endocarditis with severe valvular insufficiency (occlusive weakness of the heart valves); predominantly frequently affected are the mitral valve in front of the aortic valve and the tricuspid valve Endocarditis, which runs uncontrolled under therapy. Perivalvular abscesses (encapsulated collections of pus) in the area … Endocarditis: Surgical Therapy
The following symptoms and complaints may indicate endocarditis (endocarditis): Leading symptoms Fever, persistent, possibly chills (90% of cases accompanied by fever). Tachycardia – too fast heartbeat: > 100 beats per minute. Heart murmur (new onset) – this may change character (decrescendoform/becoming quieter; crescendoform/becoming louder) Accompanying symptoms Adynamia, i.e. general exhaustion or a pronounced lack of … Endocarditis: Symptoms, Complaints, Signs
Pathogenesis (development of disease) The following forms of endocarditis can be distinguished: Abacterial endocarditis – caused by antibody reactions; e.g., endocarditis rheumatica. Infective endocarditis – endocarditis caused by bacteria, viruses, fungi: Acute endocarditis: mainly Staphylococcus aureus (about 45-65% of cases), streptococci (about 30% of cases) and enterococci (gram-negative bacteria from the HACEK group (H – … Endocarditis: Causes
